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More than one million children in England had an active referral to mental health services during 2024–25, according to new analysis from the Children's Commissioner, which warns that demand is increasing at a faster rate than services can respond.
In her fifth annual report on children's mental health services, Dame Rachel de Souza found that 1,048,965 children had active referrals to Children and Young People's Mental Health Services (CYPMHS) during the last year, representing almost double the number recorded in 2018–19 and an increase of nearly 10% on the previous year.
The report identifies rising referrals for suspected autism, neurodevelopmental conditions and anxiety as key drivers of growing demand. Anxiety remains the most common reason for referral, accounting for 16% of all referrals, while referrals for suspected autism increased by almost 50% in a single year, rising from 65,530 to 96,393. Referrals for other neurodevelopmental conditions increased by 24%.
Despite more children accessing support, the analysis highlights a growing backlog within services. By the end of March 2025, 35% of children referred to CYPMHS were still waiting for treatment, compared with 33% in 2023–24 and 29% two years earlier. More than 60,000 children had been waiting for support for more than two years, an increase of over 15,000 compared with the previous year. Children who remained on waiting lists had waited an average of 224 days.
Children referred for suspected autism and neurodevelopmental conditions experienced some of the longest delays. Fewer than one in five children referred with suspected autism or neurodevelopmental conditions received treatment during 2024–25, while only 13% of children referred for suspected autism had accessed treatment by March 2025. Those who did receive support waited an average of a year before beginning treatment.
The report also identifies disparities in access to services. Black and Asian children remain underrepresented among referrals but are more likely to be referred at crisis point. One in four Black children referred to CYPMHS were referred because they were in crisis, compared with 16% of Asian children and 7.4% of white children, raising concerns about whether some children from ethnic minority backgrounds are receiving support early enough.
Children living in more deprived areas were also found to be more likely to be referred to mental health services and subsequently receive treatment. Children from the poorest 10% of areas accounted for 15% of referrals, compared with 7.6% from the least deprived areas. They were also more likely to access treatment and experience shorter waits.
Dame Rachel described the findings as "stark", noting that around one in ten children in England now has an active referral to mental health services. She said the figures reflected the scale of distress experienced by young people and highlighted the need for a more joined-up approach to children's wellbeing across health, education and social care.
The Commissioner argues that the forthcoming 10-Year Mental Health Strategy should include a dedicated focus on children, jointly led by the Department of Health and Social Care and the Department for Education. Among the recommendations are measures to improve early intervention, develop shared assessment frameworks for children with neurodevelopmental needs, strengthen pathways between education and health services, and introduce greater accountability for children's experiences of mental health support.
The report also highlights concerns over funding levels. Although real-terms spending on CYPMHS increased by 2% to £1.1 billion in 2024–25, this has not kept pace with rising demand. Significant regional disparities in spending also remain, with some integrated care boards spending less than £600 per child while others spend up to £2,400 per child.
To read the Commissioner's notice in full, click here.
