Children as young as six are increasingly presenting at emergency departments in England with recorded mental health concerns, and many are experiencing prolonged waits for appropriate support, an analysis by the Royal College of Paediatrics and Child Health (RCPCH) has found.
Sharp rise in attendances and extended stays
Using NHS England data, the RCPCH reported that in 2025 there were 75,491 attendances by children and young people aged 6–17 for mental health concerns, up from 55,525 in 2019 — a 36% increase. The college highlighted a particular acceleration among the youngest age group: attendances for children under 10 rose from 3,870 in 2019 to 6,269 in 2025.
Alongside rising attendance, the data indicate a marked increase in prolonged stays in A&E for mental health reasons. The number of children waiting more than 12 hours rose from 1,964 in 2019 to 6,235 in 2025. Some children faced even longer delays: 338 were recorded as spending more than 72 hours in emergency departments in 2025, compared with 55 in 2019.
“More children are reaching crisis point,”
The RCPCH warned that emergency departments are not configured to manage the complex needs of children and young people in mental health crisis and urged the Government to use the forthcoming Mental Health Strategy to prioritise prevention and earlier access to support so fewer youngsters end up in A&E.
What the figures show
| Measure | 2019 | 2025 |
|---|---|---|
| Total A&E attendances (age 6–17) for mental health | 55,525 | 75,491 |
| A&E attendances (children under 10) | 3,870 | 6,269 |
| Children waiting >12 hours in A&E | 1,964 | 6,235 |
| Children waiting >72 hours in A&E | 55 | 338 |
Context and limitations
The RCPCH figures are drawn from routine NHS England recording of attendances and waiting times. While they demonstrate a clear upward trend in presentations to emergency departments, this data do not explain underlying causes such as changes in service availability, patterns of referral, shifts in help‑seeking behaviour or prevalence of mental health conditions among children. Correlation in these administrative datasets cannot establish causation.
Children’s doctors have emphasised the vulnerability of young children’s neurodevelopment and warned that prolonged waits and care in environments not designed for mental health crises could have longer‑term consequences if early intervention is missed. The college has called for greater investment in community and early intervention services to reduce the need for emergency care.
- Rising demand: 36% more A&E attendances for mental health among 6–17 year‑olds in 2025 versus 2019.
- Youngest affected fastest: attendances among the under‑10s increased notably faster than other age groups.
- Long waits: thousands of children experienced waits exceeding 12 hours; several hundred waited more than three days for safe discharge options.
Policy implications
The findings arrive ahead of a Government‑commissioned review into attention‑deficit hyperactivity disorder, autism and broader mental health services. The RCPCH has urged ministers to ensure the upcoming Mental Health Strategy focuses on prevention, improved early help and timely specialist support so that fewer children reach the point of needing emergency care.
Delivering that change will require co‑ordinated action across health, education and social care services. Evidence from peer‑reviewed literature supports the value of early intervention in childhood mental health to improve outcomes, but effective implementation depends on workforce capacity, accessible community services and clear referral pathways — practical challenges reflected in the rising number of children ending up in A&E.
The RCPCH analysis highlights a pressing operational and policy issue for the NHS: how to reduce pressure on emergency departments while ensuring children in acute distress receive safe, timely and age‑appropriate care.
