Children in mental health crises languish on waiting lists

OPINION

Every child has a right to a safe, healthy childhood – but nearly one in 10 in England has an active referral to children’s mental health services. More than 958,000 children – eight per cent of all children in England – experienced a wait for mental health assessment or treatment, as of March 2024. Increasingly, they are ‘in crisis’: in acute distress, at serious risk of harm – even death. More of them are suffering from anxiety. Many are suspected of having autism, or ADHD.

They are crying out for help. Instead, they are wasting precious chunks of their childhoods on waiting lists, often absent from school, missing time with friends, becoming isolated. Almost a third of children still waiting for support at the end of the year had been waiting for more than a year – and when they do get treatment, it’s not always clear it will provide them with the support or care they need to get better.

Even for children with the most urgent conditions, for whom waiting times are the shortest, the average wait could be excruciating: five days ‘in crisis’, eight days for self-harm, 13 days for a suspected episode of psychosis.

Our children are lost in a system that is overwhelmed by demand and under-prioritised: in 2023 to 2024, local NHS boards spent on average just over 1% of their budgets on children’s mental health services, despite a real terms increase on the previous year.

On average, black and other ethnic minority children are less likely overall to be accessing mental health services than white children, but are more likely to come to their attention at crisis point - well past the point of prevention.

As one teenager told me: “Many of my friends have self-harmed, had eating disorders or had suicidal thoughts. …They never reached out for help. The children’s mental health system and general school counselling system have a terrible reputation - many believe that going there ‘only makes things worse’.”

We need to stop asking children to prove they are unwell enough to deserve help.

As Children’s Commissioner, when I ask children what makes them unhappy, their answers are clear and consistent: families struggling to afford food, feeling unsafe in their neighbourhoods or at home, being misunderstood at school, feeling isolated, unseen, disconnected. 

Even the most skilled mental health and wellbeing practitioners cannot provide the antidote to these challenges alone: they are collective problems that require collective solutions with all the agencies in a child’s life working together, across education, health and social care. 

For the first time, I believe we have a genuine opportunity to change how we approach public health in this country, through the NHS 10 Year Plan. This plan must have children’s mental health at its heart, putting children’s health on par with adults’ and shifting from diagnosis-led treatment to earlier intervention and prevention.

Grasping this opportunity for change means responding to those things that children tell me make them unhappy – because for hundreds of thousands of children, the barrier to opportunity is their mental health.

It means creating a system that allows children to get help without needing a label, one where support is not dependent on getting hold of a medical diagnosis.

It means setting a clear, ambitious direction for a fairer share of investment in children and young people’s mental health and wellbeing services – right across the spectrum of need.  

And it means a model of care that listens earlier, acts faster and supports every child – and allows professionals to spend less time on lengthy assessments and more actually supporting children, especially in school.  

I can think of no better public health approach than treasuring childhood, and giving young people the building blocks for long, happy, fulfilling adult lives. 

I hope our leaders are ready to seize the moment, because our children can’t wait.