Royal colleges have blamed a catastrophic system-wide failure
for a mental health crisis affecting children and young people in England, following the revelation of figures showing more than half a million emergency department attendances over a five-year period.
Children in Mental Health Crisis Face Catastrophic System-Wide Failures
Data obtained under the Freedom of Information Act from 80 out of 125 acute NHS trusts in England revealed that from 2019 to 2025, there were over 330,000 reported cases of individuals aged under 18 presenting with mental ill-health at accident and emergency departments in the two-thirds of trusts that responded. This total represented an average of 47,000 presentations per year. By extrapolating this information, the RCN estimated that over half a million children and young people nationally presented at A&E departments with mental health conditions across the five-year timeframe.
Prolonged A&E Waits and Regional Increases
The figures indicate that children facing severe distress are experiencing lengthy delays within emergency care settings. The number of young people forced to wait for 12 hours or more in emergency departments before being transferred to a mental health unit nearly tripled, rising from 237 in 2019 to more than 800 in 2025, with some individuals waiting up to three days. Professor Nicola Ranger, general secretary and chief executive of the RCN, told the union’s annual conference that these statistics provided clear evidence of a widespread system failure.
- University Hospitals Birmingham NHS Foundation Trust recorded an increase of over a third in children attending A&E between 2019 and 2025.
- University Hospitals Bristol and Weston NHS Foundation Trust saw attendances rise by 76% over the same period.
- Nationally, referrals to NHS children’s and adolescent mental health services have tripled over the past 10 years.
Calls for Urgent Government Intervention
Healthcare professionals and mental health charities have stressed that emergency departments are ill-suited for vulnerable young patients. Dr Sam Jones, RCPCH officer for mental health, stated that a lack of wider mental health care and crisis support in many parts of the country meant vulnerable children were missing out on necessary assistance. 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 said, adding that emergency departments were never designed to be places where children wait for days at a time.
Dr Mark Buchanan of the Royal College of Emergency Medicine noted that children in crisis were ending up in A&E by default
rather than receiving care in appropriate settings. Gemma Byrne from the mental health charity Mind added that spending more than 12 hours in A&E is simply unacceptable for a child, pointing out that current services often only provide support when young people are deemed unwell enough
to qualify.
To combat the crisis, the RCN and RCPCH have urged the government to protect children from potentially traumatising A&E visits by expanding the rollout of mental health emergency units. These specialized units were included in a government 10-year plan published previously, which featured a commitment to spend £120 million on a network of 85 facilities to provide rapid walk-in assessments.
Government Strategy and Future Steps
The Department of Health and Social Care announced the development of a cross-government mental health strategy to address rising demands, particularly among children and young people. A Department spokesman stated that improvements were already underway through investments in mental health teams for schools and more than 150 new community hubs located in places such as banks and libraries.
Claire Evans of the children’s mental health charity Anna Freud emphasized that any new strategy must place children at its core.
