"A distressing surge in children as young as six presenting at A&E with mental health emergencies underscores a national crisis, revealing a systemic failure in providing adequate community support and leaving vulnerable young people with nowhere else to turn."
England’s emergency departments are grappling with an alarming and sustained increase in children and young people seeking help for severe mental health concerns, a situation NHS doctors are now unequivocally labelling a national crisis. The sharp rise in attendances, disproportionately affecting the youngest demographics, highlights critical gaps in the mental health support infrastructure outside of acute hospital settings. This escalating trend not only places immense strain on already stretched A&E services but also exposes children and their families to environments ill-equipped to address complex psychological distress, often resulting in prolonged and potentially traumatising waits.
New analysis from the Royal College of Paediatrics and Child Health (RCPCH) paints a stark picture of this unfolding crisis. Between 2019 and 2025, there was a staggering 36% increase in A&E attendances by six to 17-year-olds for mental health-related issues. This surge, far outstripping the general rise in A&E visits, saw the number climb from 55,525 in 2019 to 75,491 in 2025. What is particularly concerning is that some of the most significant increases were observed among very young children aged six to nine, a demographic typically less associated with such acute psychological distress, indicating a deepening and broadening of the crisis across age groups.
These emergency presentations encompass a wide spectrum of severe conditions, including self-harm, acute eating disorders, and profound emotional crises that can manifest as aggressive or challenging behaviour. Families, carers, and even police are frequently the ones bringing these children to A&E, often as a last resort when all other avenues for support have been exhausted or proven inaccessible. The very nature of these presentations underscores the urgency and severity of the mental health conditions, demanding immediate and specialised intervention that A&E units are fundamentally not designed to provide.
The consequence of this reliance on emergency care is dire for the young patients. Data reveals that over 6,200 children and young people, approximately 8% of all mental health attendees, faced waits exceeding 12 hours in A&E departments. Such extended periods in a high-pressure, often chaotic and frightening environment can exacerbate a child’s distress, potentially causing further trauma and hindering their ability to engage with subsequent mental health support. Emergency departments, while serving as a vital safety net, are primarily geared towards physical emergencies and lack the dedicated space, trained staff, and therapeutic environment necessary for sensitive mental health care, especially for children.
Dr. Sam Jones, RCPCH officer for mental health, articulated the core issue with grave concern. She emphasised the critical lack of wider mental health care and, crucially, crisis support available within communities across much of the country. "Behind every one of these figures is a child or young person in distress and a family who didn’t know where else to turn," Dr. Jones stated, highlighting the human cost of systemic failings. She reiterated that while emergency departments are indispensable, they were never intended to be long-term holding bays for children in mental health crisis. This situation, she warned, is a "national crisis that will only get worse without urgent intervention," calling for significant investment in children’s mental health services and enhanced training for staff across health, social care, and education sectors to better support struggling children.
Echoing this sentiment, Dr. Mark Buchanan of the Royal College of Emergency Medicine (RCEM) described children and young people in mental health crisis ending up in A&E by "default." He stressed that these vulnerable individuals "deserve care within systems and settings that are designed to meet their needs," underscoring the mismatch between the services offered by A&E and the specific requirements of mental health patients. The overburdening of emergency departments with mental health cases also diverts resources from physical emergencies, creating a ripple effect across the entire healthcare system.
The human impact of these long waits in an inappropriate setting was further elaborated by Gemma Byrne of the mental health charity Mind. "A&E can be a frightening environment for anyone in mental health crisis, let alone a child. Making them spend more than 12 hours there is simply unacceptable," she asserted. Byrne pointed to a fundamental flaw in the current system, where many mental health services only offer support once young people are deemed "unwell enough" to qualify. This high threshold for entry into specialist services means preventative and early intervention care is often missed, allowing conditions to escalate to crisis point before help is accessible. Mind advocates for expanding the network of "young future hubs," which offer integrated support encompassing mental health, employment, sports, and volunteering, as a crucial step towards a more proactive and holistic approach.
The government acknowledges the severity of the situation and is expected to publish a new mental health strategy later in the summer. A Department of Health and Social Care spokesman stated that improvements are already underway, citing investment in mental health teams for schools and the establishment of more than 150 new mental health hubs in accessible community locations such as banks and libraries. The spokesman affirmed, "No child should have to reach crisis point before getting the support they need," a sentiment that resonates deeply with the concerns raised by healthcare professionals and charities.
However, the scale of the challenge suggests that current measures, while positive, may not be sufficient to stem the tide of the crisis. Claire Evans, from the Anna Freud Centre, a leading mental health charity for children, young people, and families, described the figures as "deeply concerning." She emphasised that the forthcoming mental health strategy must unequivocally "place children at its heart, creating the conditions for lifelong positive mental health and accelerating investment in accessible, community-based support."
The root causes of this escalating crisis are multifaceted and complex. Factors such as the long-term impact of the COVID-19 pandemic, increased academic pressures, the pervasive influence of social media, rising cost-of-living concerns, and a general decline in societal resilience are all believed to contribute to the worsening mental health landscape for young people. Furthermore, years of underinvestment in Child and Adolescent Mental Health Services (CAMHS) have created significant workforce shortages, lengthy waiting lists for specialist care, and a fragmented system that struggles to meet demand.
Addressing this crisis requires a comprehensive, multi-pronged approach that extends beyond the immediate relief of A&E. It necessitates a paradigm shift towards early intervention, prevention, and robust community-based services that can intercept distress before it escalates. This includes bolstering school-based mental health support, ensuring timely access to specialist CAMHS, developing dedicated crisis teams for young people, and fostering a societal environment that prioritises mental well-being from the earliest years. Without such systemic reform and substantial, sustained investment, the distressing trend of children in mental health crisis overwhelming A&E departments is set to continue, with profound and lasting consequences for the well-being of a generation.
