Child mental health crisis as one million seek help for anxiety and autism in England

More than a million children in England are currently engaged with mental health services, a figure described as revealing the "sheer scale of distress young people are facing today". The Children's Commissioner, Dame Rachel de Souza, has declared that the nation is "in no doubt that we are facing a crisis in young people's mental health".

Her annual report, published on Monday, revealed that 1,048,965 children had active referrals to children and young people's mental health services in the 12 months leading up to March 2025. This figure encompasses children who were referred for, awaiting, or receiving treatment during that period, though it excludes those already undergoing treatment at the start of the year.

The number of active referrals has almost doubled from 563,639 in 2018-19, with a 9.5 per cent increase in the last year alone. While Dame Rachel noted there appeared to be "no straightforward answers" to the surge, data obtained from NHS England by her office indicates anxiety as the primary reason for referrals.

Demand is also "growing especially" for those referred with suspected autism and other neurodevelopmental conditions.

A government review published in March highlighted that there is no "single narrative" explaining the rise in autism and attention deficit hyperactivity disorder (ADHD) diagnoses within children's mental health services. That report suggested "rising distress" among young people as a contributing factor, alongside a "medicalisation of distress" where diagnosis can become the main route to support.

It also cautioned that increased diagnoses for ADHD and autism do not necessarily equate to a rise in prevalence, but could reflect improved recognition, changes in help-seeking behaviour, and evolving social patterns.

Dame Rachel's report detailed significant increases in specific referral types. Referrals for suspected autism soared by 47 per cent, from 65,530 to 96,393. Other neurodevelopmental conditions saw an almost quarter increase, rising from 107,479 to 133,435. Meanwhile, anxiety referrals climbed by 12 per cent, from 151,479 to 169,389.

Anxiety accounted for 16 per cent of all referrals in the year to March 2025, with neurodevelopmental conditions (excluding autism) making up 13 per cent, suspected autism 9.2 per cent, and depression 3.9 per cent. Children under 10 were more frequently referred for neurodevelopmental conditions, particularly suspected autism for those aged six and younger, while anxiety was the most common reason for referrals among children over 10.

The report also exposed concerning waiting times, with a weighted average of 128 days for all children in the year ending March 2025. Of those still awaiting treatment at that point, 60,041 (16 per cent) had been waiting for over two years, an increase from 14 per cent the previous year, with waits exceeding a year described as "common".

Dame Rachel branded the figures "stark", stating: "Roughly one in 10 children have an active referral to mental health services in England, which clearly demonstrates the sheer scale of distress young people are facing today. 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 acknowledging "encouraging signs" as more children received support last year, she warned of a "colossal challenge facing mental health services, as demand outpaces system capacity and funding".

Dame Rachel urged a fundamental shift in approach: "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 concluded by advocating 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, only then will we stop asking what is wrong, but rather 'how can we help?'"

She views 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".

The Independent