More than one million children across England were referred to, waiting for, or receiving treatment from mental health services in the year to March 2025, according to data analysis by the Children's Commissioner for England, Dame Rachel de Souza. The figure, representing roughly one in 10 children, has nearly doubled from 563,639 in 2018-19 and increased by 9.5% in the past year alone.
Children's Commissioner Warns of Crisis
Dame Rachel de Souza said she is "in no doubt that we are facing a crisis in young people's mental health." She described the figures as "stark" and noted that "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 there appear to be "no straightforward answers" to what is driving the rise, data obtained by her office indicates anxiety is the primary reason for referrals, with demand "growing especially" for those referred with suspected autism and neurodevelopmental conditions.
Active Referrals and Waiting Times
There were 1,048,965 children with active referrals to children and young people's mental health services in the 12 months to March 2025. Active referrals encompass children who have been referred for, were awaiting, or received treatment during that timeframe, though the figures exclude children already undergoing treatment at the start of the period. The weighted average waiting time for all children stood at 128 days, and of those still awaiting treatment, 60,041 (16%) had been waiting longer than two years, up from 14% the previous year. The report warned that waits exceeding a year were "common."
Referral Breakdown by Condition
Figures obtained from NHS England reveal that the sharpest year-on-year rise was in referrals for suspected autism, jumping by 47% from 65,530 to 96,393. Referrals for other neurodevelopmental conditions climbed by nearly a quarter, from 107,479 to 133,435. Meanwhile, referrals for anxiety increased from 151,479 to 169,389, a rise of 12%. Anxiety accounted for 16% of all referrals, neurodevelopmental conditions excluding autism made up 13%, suspected autism represented 9.2%, and depression accounted for 3.9%. Children under 10 were more likely to be referred with neurodevelopmental conditions, specifically suspected autism for those aged six and younger. For youngsters aged over 10, anxiety was the most frequent reason for referral.
Government Review and Medicalisation Debate
The report references a Government review published in March, which concluded there is no "single narrative" for the rise in rates of autism and ADHD regarding demand for children's mental health services. The review highlighted "rising distress" among younger people as a key factor driving increased demand, while also drawing attention to a "medicalisation of distress" that can result in a diagnosis becoming the "main route of support." The report's authors noted that growing rates of diagnosis for ADHD and autism "does not necessarily mean rising prevalence" of these conditions, but could instead be due to "improved recognition, changes in help-seeking behaviour, evolving social patterns, and the possibility that under-recognition may persist in parts of the population."
Calls for Systemic Change
Dame Rachel acknowledged "encouraging signs" as greater numbers of children received support last year, but warned of a "colossal challenge facing mental health services, as demand outpaces system capacity and funding." She stated: "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." She called for a shift towards joined-up services across health, education and social care to ensure children get the help they need in schools and the community, adding: "Only then will we stop asking what is wrong, but rather 'how can we help?'" She described the Government's mental health strategy and reforms to the special educational needs and disabilities (Send) system as a "once in a generation opportunity to transform children's mental health and improve outcomes for children."
