More than one million children referred to mental health services, commissioner finds

More than one million children in England had an active referral to Children and Young People's Mental Health Services (CYPMHS) last year for the first time, according to a new report from the Children's Commissioner, which warns that demand is rising faster than services can respond.

The fifth annual report on children's mental health services, published by Children's Commissioner Dame Rachel de Souza, found that 1,048,965 children had an active referral to CYPMHS during 2024-25. This represents almost double the number recorded in 2018-19 and an increase of almost 10 per cent on the previous year.

Despite more children receiving treatment than previously, the report highlights a growing backlog, with 35 per cent of referred children still waiting for treatment at the end of March 2025, compared with 33 per cent a year earlier and 29 per cent in 2022-23. More than 60,000 children had been waiting for support for more than two years, up from more than 44,000 the previous year.

The analysis found referrals for suspected autism and other neurodevelopmental conditions are among the fastest-growing reasons children are seeking support. Referrals for suspected autism rose by almost 50 per cent in a single year, from 65,530 to 96,393, while referrals for other neurodevelopmental conditions increased by 24 per cent.

However, children referred with suspected autism were among those most likely to experience the longest waits. Fewer than one in five children referred for suspected autism or neurodevelopmental conditions went on to receive treatment during 2024-25, while only 13 per cent of children referred for suspected autism had received treatment by March 2025. Those who did receive support waited an average of a year.

The report also highlights inequalities in access to support. Black and Asian children were underrepresented in referrals but were significantly more likely than white children to be referred when already in crisis. One in four Black children referred to CYPMHS were referred in crisis, compared with 16 per cent of Asian children and 7.4 per cent of white children.

Meanwhile, younger children were more likely to experience longer waits and have their referrals closed before treatment, suggesting gaps in early intervention.

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."

She argued that improving children's mental health requires a coordinated approach across health, education and social care, rather than focusing on clinical services alone.

"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?’."

The Commissioner is calling for the government's forthcoming 10 Year Mental Health Strategy to include a dedicated children's mental health strategy jointly owned by the Department of Health and Social Care and the Department for Education. Among the recommendations are the creation of shared assessment pathways for children with neurodevelopmental needs, alternative support pathways for children affected by trauma and learning disabilities, and improved accountability for children's experiences of mental health services.

The report also raises concerns that funding is failing to keep pace with demand. While real-terms spending on CYPMHS increased by two per cent to £1.1 billion in 2024-25, referrals increased by almost 10 per cent over the same period. Regional variation in spending also remains significant, ranging from under £600 per child in Kent and Medway to around £2,400 per child in North West London.

Looking ahead to wider reforms, Dame Rachel said: "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."