Emergency departments across England are facing a mounting crisis as the number of children and young people arriving in acute mental distress has climbed sharply, new analysis reveals. Between 2019 and 2025, attendances by six to 17-year-olds seeking help for self-harm, eating disorders and emotional emergencies jumped by 36%, according to data compiled by the Royal College of Paediatrics and Child Health from Freedom of Information requests to NHS England.
The figures paint a stark picture of a healthcare system struggling to cope. In 2025 alone, 75,491 children and young people attended A&E units for mental health concerns, compared with 55,525 six years earlier. The growth rate far exceeds the 8% rise in overall A&E attendances during the same period, suggesting that mental health crises among the young are becoming an increasingly dominant driver of emergency department demand. Particularly alarming is the surge among very young children aged six to nine, where some of the steepest increases have been recorded.
According to the Royal College of Nursing, approximately half a million children and young people have attended NHS emergency departments in a mental health crisis since 2019. Many face unacceptable delays: in total, more than 6,200 young people—around 8% of those attending—waited over 12 hours in A&E, with some enduring waits of up to three days for a specialist bed.
The children and young people presenting at emergency departments arrive through multiple pathways. Families, carers and police bring them in, often when they are in emotional distress or displaying aggressive or challenging behaviour. Medical professionals emphasise that these are among the most vulnerable members of society, yet the environment in which they find themselves waiting is fundamentally unsuited to their needs.
Why are children ending up in A&E instead of specialist services?
The core problem, according to medical leaders, is the absence of adequate crisis support in community settings. Dr Sam Jones, the Royal College of Paediatrics and Child Health's officer for mental health, described a system where families have nowhere else to turn.
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. Emergency departments are a vital safety net, but they were never designed to be a place where children in mental health crisis wait for days at a time. This is a national crisis that will only get worse without urgent intervention.
Dr Mark Buchanan of the Royal College of Emergency Medicine characterised the situation as one where vulnerable young people are ending up in A&E by
default, rather than through any deliberate clinical pathway.
They deserve care within systems and settings that are designed to meet their needs.
The problem extends beyond the immediate crisis response. According to NHS England, its children and young people mental health work now includes improving care for children in residential settings and reducing repeated emergency department visits, acknowledging that the current system is generating repeat attendances rather than resolving underlying issues.
What barriers prevent early intervention?
Gemma Byrne, policy manager at the mental health charity Mind, highlighted a structural flaw in how services are rationed. Many mental health services only provide support once young people are deemed
unwell enoughto qualify, she explained, creating a perverse incentive where children must deteriorate to crisis point before receiving help.
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.
This gatekeeping approach means that early intervention—the most effective and humane approach—is often unavailable. Instead, children spiral into crisis, their families become desperate, and emergency departments become the only option. Byrne advocated for expanding young futures hubs, which integrate mental health support with employment, sports and volunteering opportunities in accessible community locations.
The government has already begun rolling out such infrastructure. A Department of Health and Social Care spokesman noted that improvements are underway, including investment in mental health teams embedded in schools and the opening of more than 150 new mental health hubs in community settings such as banks and libraries. However, these initiatives remain nascent, and the scale of need far outpaces current provision.
What does the data reveal about waiting times?
According to the Royal College of Nursing's analysis, the number of under-18s waiting over 12 hours for admission to a mental health unit more than tripled, rising from 237 in 2019 to 802 in 2025. This represents not merely longer waits but a fundamental failure to meet national guidance. NHS England's long-term guidance specifies that a face-to-face assessment for mental health needs in an emergency department should start within one hour from referral, yet many children are waiting many times longer.
The same analysis found that there were over 330,000 reported cases of under-18s with mental ill-health presenting at A&Es across 70 trusts from 2019 to 2025 inclusive. This figure underscores the scale of the phenomenon and suggests that the 75,491 attendances recorded in 2025 alone represent only a portion of the full picture, as not all trusts may have provided complete data.
What is the broader context?
This crisis in emergency mental health care for children sits within a wider landscape of strain across children's mental health services. Referrals to children's mental health services in England exceed one million, with anxiety the leading cause, and suspected autism and other neurodevelopmental conditions have also risen sharply, amid long waits and disparities in access. Additionally, research has revealed that vulnerable children in care are deliberately self-harming to avoid losing support at age 18, highlighting how systemic failures can drive harmful coping mechanisms.
Claire Evans of Anna Freud, a mental health charity for children, young people and families, warned that the figures are deeply concerning and called for systemic change.
The new mental health strategy must place children at its heart, creating the conditions for lifelong positive mental health and accelerating investment in accessible, community-based support.
What happens next?
The government is planning to publish a new mental health strategy later in the summer. A Department of Health and Social Care spokesman stated that
no child should have to reach crisis point before getting the support they need, signalling an acknowledgment of the problem, though critics argue that rhetoric must translate into substantial funding and service redesign.
NHS England's children and young people mental health programme continues to roll out service changes aimed at better crisis care and fewer emergency department visits. Regular A&E performance statistics are published monthly by NHS England, allowing ongoing monitoring of whether attendances by children in mental health crisis begin to decline as new services come online.
Key Facts:
- Mental health A&E attendances by six to 17-year-olds rose 36% between 2019 and 2025, from 55,525 to 75,491 annually
- More than 6,200 young people (8% of attendees) waited over 12 hours in A&E, with some facing waits of up to three days for specialist beds
- The number waiting over 12 hours for admission to a mental health unit tripled from 237 in 2019 to 802 in 2025
- Growth in mental health A&E attendances far outpaces the 8% rise in overall A&E demand over the same period
- The government plans to publish a new mental health strategy in summer 2026, with over 150 new community mental health hubs already operational
