More than one million children in England are currently receiving mental health support, with official figures revealing that one in ten young people now has an active referral to specialist services. The Children’s Commissioner, Dame Rachel de Souza, said the numbers laid bare the “sheer scale of distress young people are facing today” and warned that the nation was “in no doubt that we are facing a crisis in young people’s mental health.”
Her annual report, published on Monday, shows that 1,048,965 children had active referrals to Children and Young People’s Mental Health Services (CYPMHS) in the 12 months to March 2025 — encompassing those referred, awaiting treatment, or receiving care during that period, though excluding those already in treatment at the start of the year. The figure has almost doubled from 563,639 in 2018-19, with a 9.5 per cent increase in the last year alone.
The surge in demand is being driven by a combination of mounting anxiety and a sharp rise in referrals for suspected autism and other neurodevelopmental conditions. Data obtained from NHS England by the Commissioner’s office shows that anxiety remains the single most common reason for referral, accounting for 16 per cent of all cases in the year to March 2025 — a 12 per cent increase from 151,479 to 169,389 referrals. But the fastest-growing category is suspected autism, where referrals soared by 47 per cent, from 65,530 to 96,393. Referrals for other neurodevelopmental conditions rose by almost a quarter, from 107,479 to 133,435, making up 13 per cent of all referrals.
Age plays a clear role in determining the type of support children need. Those under ten are far more likely to be referred for neurodevelopmental conditions, particularly suspected autism among children aged six and younger. For children over ten, anxiety is the dominant reason. Depression accounted for 3.9 per cent of all referrals.
A government review published in March cautioned that there is no single explanation for the increase in autism and ADHD diagnoses within children’s mental health services. It pointed to “rising distress” among young people as a contributing factor, alongside what it described as a “medicalisation of distress” — where obtaining a diagnosis becomes the main route to accessing support. The review also noted that higher diagnosis rates do not necessarily mean more children are developing these conditions; improved recognition, changing help-seeking behaviour, and evolving social patterns may all play a part.
Separate research has highlighted broader societal pressures. Extended social media use — more than three hours per day — is linked to increased depression and anxiety in children, particularly girls, largely due to disrupted sleep patterns. Socioeconomic factors are also stark: children from the poorest 20 per cent of households are four times more likely to have serious mental health difficulties by age 11 than those from the wealthiest 20 per cent. Regional disparities exist too, with children in the North of England more likely to experience mental health difficulties, linked to cumulative adversity and poorer access to support. Black and Asian children are underrepresented in referrals but more likely to be referred at crisis point.
The impact on education is severe. Children with mental health difficulties are three times more likely to miss significant amounts of school, and 74 per cent of teachers believe poor mental health negatively affects pupils’ ability to learn.
Waiting times and the growing backlog
The report exposed deeply concerning waiting times. The weighted average wait for all children in the year ending March 2025 was 128 days, but other data from the period between September and November 2025 suggests a far longer average of 304 days between referral and support. Of those still awaiting treatment at the end of March 2025, 60,041 children — 16 per cent — had been waiting for more than two years, up from 14 per cent the previous year. This represents an increase of over 15,000 children compared to the previous year. Waits exceeding a year are described as “common,” and in the worst cases young people have waited more than 976 days — over two and a half years — between referral and accessing support.
Children referred with suspected autism and neurodevelopmental conditions are among those most likely to face the longest delays. Fewer than one in five children with suspected autism or neurodevelopmental conditions received treatment in 2024-25, and those who did get support waited an average of a year for treatment. Overall, 35 per cent of children referred to CYPMHS were still waiting by the end of March 2025, up from 33 per cent in 2023-24 and 29 per cent in 2022-23.
Dame Rachel called the figures “stark,” adding: “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 she acknowledged “encouraging signs” that more children did receive support last year, she warned of a “colossal challenge facing mental health services, as demand outpaces system capacity and funding.”
Systemic change and government response
The Commissioner urged a fundamental shift in approach, arguing that mental health cannot be tackled in isolation. “Improving children’s wellbeing requires action across government,” she said, calling for “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.” She added: “Only then will we stop asking what is wrong, but rather ‘how can we help?'”
The government’s upcoming 10-Year Mental Health Strategy, alongside reforms to the Special Educational Needs and Disabilities (SEND) system, is seen by Dame Rachel as a “once in a generation opportunity to transform children’s mental health and improve outcomes for children.” An independent review into mental health conditions, ADHD, and autism, led by Professor Peter Fonagy, is underway with findings expected in summer 2026; an interim report has already been published.
On the ground, the NHS is expanding Mental Health Support Teams (MHSTs) in schools and colleges. As of spring 2025, over 600 MHSTs are operational, reaching 52 per cent of the pupil population, with a goal of covering 100 per cent of schools by 2029-30. A £7 million funding boost has also been provided for 24 existing early support hubs, aiming to deliver 10,000 additional mental health and wellbeing interventions over the next 12 months. These hubs offer drop-in support for young people aged 11-25, bypassing the need for a formal referral. The government plans to roll out “Young Futures Hubs” to provide open-access mental health support more widely.
Yet the scale of the challenge remains immense. Rates of probable mental disorder in children aged 5-16 rose from one in nine (10.8 per cent) in 2017 to one in six (16.0 per cent) by 2020. By 2023, around one in five children and young people aged 8-25 had a mental health difficulty. Suicide was the leading cause of death for people aged 5-35 in England in 2022, and almost a third (32.8 per cent) of 17-24 year olds have self-harmed or attempted to self-harm at some point. Around one in three young carers also experience a mental health problem.