(ENGLAND) Over a million children referred for mental health services; autism, neurodevelopmental referrals driving growth
- 2 days ago
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Demand for children’s mental health services continues to soar, outstripping system capacity and investment, with referrals almost doubling since 2018-19
Referrals up almost 10 per cent in previous year with more children receiving support, but over a third were still waiting for treatment with more than 60,000 children waiting over two years for help
New analysis shows demand driven in part by children being increasingly referred for suspected autism and neurodevelopmental conditions, these children were most likely to face some of the longest waits for help
Children’s Commissioner calls the Department of Health’s national mental health strategy to have a specific focus on children, with the Department for Education, that includes measures to hold services to account
Demand for children’s mental health services is rising – and rising faster than in previous years – the Children’s Commissioner has warned, as for the first time more than a million children in England had active referrals to mental health services in England last year – leaving increasing numbers of children waiting for months or years for support.
In her fifth annual report on children’s mental health services, Dame Rachel de Souza sets out how the growing demand for services is placing growing pressure on support for children. New data for 2024-25 shows that 1,048,965 children had an active referral to Children and Young People’s Mental Health Services (CYPMHS) – almost double the number recorded in 2018-19, and almost 10 per cent rise on the previous year.
Today’s report reveals demand for services rose most sharply among children referred for suspected autism, neurodevelopmental conditions and anxiety, with anxiety remaining the most common referral reason to CYPMHS – accounting for 16 per cent of overall referrals.
Despite these sharp rises in referrals, children with suspected autism and neurodevelopmental conditions were among the most likely to still be waiting for any treatment by March 2025. Fewer than one in five children with suspected autism or neurodevelopmental conditions went onto to receive treatment in 2024-25. . . .
Children’s Commissioner Dame Rachel de Souza said:
“There is no disguising the fact the figures in this report are stark. Roughly one in 10 children have an active referral to mental health services in England which clearly demonstrates the sheer scale of distress young people are facing today. These are not just numbers, but children whose lives have been put on hold for months and, in some cases, years waiting for support they urgently need.
“While there have been some encouraging signs, with more children receiving support last year, it is hard to ignore the colossal challenge facing mental health services, as demand outpaces system capacity and funding.
“The way we look to support young people’s mental health must change – we cannot address mental health alone in isolation, improving children’s wellbeing requires action across government. At the same time, there must be shift in how we approach children’s mental health with greater focus on joined up services across health, education and social care to ensure children are getting the help they need in schools and the community, only then will we stop asking what is wrong, but rather ‘how can we help?’.
“With the upcoming 10 Year Mental Health Strategy and reforms to the SEND system, we have a once in a generation opportunity to transform children’s mental health and improve outcomes for children. In order for these to have the most impact they must be shaped and informed by children’s own experiences and must be done collaboratively – not working in isolation – so that services offer earlier support, shorter waits and reflect what young people say they need to thrive.” . . .
Record demand: More than a million children had an active referral to CYPMHS, with referrals most doubling since 2018-19, and growing by almost 10 per cent in the last year alone.
Autism and neurodevelopmental referrals driving growth: Referrals for suspected autism rose by almost 50 per cent in a single year, from 65,530 to 96,393. Referrals for other neurodevelopmental conditions increased by 24 per cent, making these among the fastest growing reasons children are seeking support.
Growing backlog: Slightly more children are receiving treatment than in the previous year, but more children are also waiting for support. Over a third of children (35 per cent) referred to CYPMHS were still waiting for treatment at the end of the year, up from 29 per cent two years earlier.
Children waiting years for help: More than 60,000 children had been waiting over two years for treatment by the end of March 2025 – an increase of more than 15,000 compared to the previous year. Children waiting for support waited an average of 224 days.
Long waits for neurodevelopmental support: Children referred with suspected autism faced some of the worst outcomes – with just 13 per cent going on to receive treatment by March 2025, and those who did receive treatment waited a year on average for support. . . .
Real term spending on CYPMHS increased by two per cent to £1.1 billion in 2024-25, following the pattern of increased spend over time. However, this compares with an almost ten per cent increase in referrals over the same time period, highlighting that spending is not keeping up with rising demand. . . .
In her report Dame Rachel highlights that not enough is being done to prevent mental health conditions developing, as referrals to CYPMHS continue to rise. Her report makes a number of recommendations including:
A joint strategy for children’s mental health: The government recently announced a new mental health strategy. It is essential that as part of this there is a specific focus on children, jointly owned by the Department of Health and Social Care and the Department for Education, to ensure children with additional needs, neurodevelopmental and mental health conditions are receiving help at the earliest point possible. This must:
Address the drivers of poor mental health and wellbeing.
Ensure a robust evidence base for treatments and interventions are provided in schools, the community and inpatient settings.
Create a shared and agreed assessment framework between health and education for children presenting with neurodevelopmental needs and develop a consistent, shared pathway between community paediatrics and CYMPHS for these children.
Develop alternative pathways which ensure suitable provision for children with complex social, emotional and mental health needs resulting from trauma, and children with learning disabilities and / or autism with escalating needs.
Introduce better data and accountability for children’s experience of mental health services. The strategy must include an outcomes framework that assesses children’s journeys through the system and the effectiveness of treatment and interventions.
Health must be an equal partner in reforms to the Special Educational Needs and Disabilities system. In the Children’s Commissioner’s role in overseeing the delivery of the SEND reforms, both the DfE and DHSC will be held to account and measurement of success will be underpinned by children’s experiences. . . .
