England child mental health referrals surge as waiting lists grow

England’s child mental health system is being pulled in too many directions at once: 949,200 children and young people were referred to Children and Young People’s Mental Health Services in 2023-24, and more than one million were in contact with NHS mental health, learning disability and autism services overall. The numbers show demand climbing far beyond the capacity to respond, with anxiety standing out as the clearest warning sign.

The most common reason for referral among under-18s last year was anxiety. Official figures cited by the Children’s Commissioner for England showed 204,526 new referrals for patients aged 17 and under where anxiety was the primary cause in 2023-24, up from 98,953 in 2019-20, before Covid-19. Dame Rachel de Souza said that works out at more than 500 children a day being referred for anxiety, a pace that has left schools, parents and clinicians dealing with symptoms long before treatment begins.

The backlog behind those referrals was already severe in 2022-23. More than 270,300 children and young people were still waiting for support after referral, 372,800 referrals were closed before the child or young person accessed care, and nearly 40,000 children faced waits of at least two years. Those figures suggest the bottleneck is not simply at the point of referral but in the handoff to treatment, where families can be left cycling between services, crisis lines and emergency care while the queue lengthens.

The waits are also uneven. The commissioner later warned that some young people wait up to 17 times longer than others depending on where they live, underscoring a postcode lottery in access to care. In practice, that means a child’s chance of getting support can depend as much on local workforce shortages and service capacity as on clinical need, with pressure spilling into classrooms, primary care and crisis teams when early help is delayed.

Dame Rachel de Souza has said the scale of need shows a crisis in young people’s mental health and called for renewed investment and reform through the NHS 10 Year Plan. The Royal College of Psychiatrists said its child and adolescent psychiatrists have seen a dramatic rise in anxiety and other mental illnesses among children and young people. NHS England says it is using the latest mental health plan and services data to improve support, while NHS Digital now tracks referrals, access and waiting times across 2016-2025 and published supplementary waiting-times data for children and young people’s mental health services in February 2025.