CAMHS: Steep rise in mental health figures is tip of the iceberg

Written by: Pete Henshaw | Published:
Image: Adobe Stock

The dramatic and alarming increase in the number of children and young people being treated for mental health problems is just the tip of the iceberg.

New NHS data shows that there has been a 54% increase in the number of under-18s undergoing mental health treatment or waiting to start care in the last two years.

In February 2020, the figure stood at around 272,000 children and young people. This had reached 411,000 in January this year and the latest figures for February 2022 show that it has now hit 420,000.

The figures refer to under-18s who are under the care of child and adolescent mental health services (CAMHS) or waiting to see a specialist. It is the highest number ever recorded and there are fears that already-stretched CAMHS will be overwhelmed.

It is well known that the threshold for accessing CAMHS is high and has been so for some time now; even before the pandemic many young people were being turned away from specialist services.

And the situation seems certain to worsen. Earlier this year, the children’s commissioner Dame Rachel de Souza raised concerns that the number of referrals to CAMHS fell during the pandemic and will likely begin to increase again in the coming years.

In her briefing, she reported that in 2020/21, only 498,000 children and young people were referred, compared to 537,000 the year before. She also warned that only 32% of children with a probable mental health disorder are accessing treatment. This calculation is based on NHS figures estimating that one in six children and young people now have a probable mental health condition.

It is clear that the pandemic has exacerbated a range of mental health issues for children and young people:

  • The number of children assessed by councils as having a mental health need has risen sharply. In March 2021, 77,390 children were assessed as having a mental health need, compared to 61,830 two years earlier. This equates to 1,500 children a week being referred for mental health support according to the Local Government Association (LGA, 2022).
  • The vast majority of school staff are seeing increased levels of anxiety among their pupils, but only a fifth say they can access specialist support for children who need it. A survey by Place2Be and the National Association of Head Teachers asked 1,130 school leaders and teachers what they were seeing. They reported increased anxiety (95%), low self-esteem (86%), depression (76%), self-harm (72%), suicidal thoughts (61%), eating difficulties (56%).
  • A survey of 1,000 GPs by mental health charity stem4, reported that half of referrals for under-18s with anxiety, depression, and self-harm were rejected by CAMHS because symptoms were not seen serious enough.

Research from the Education Policy Institute just before the pandemic (Crenna-Jennings & Hutchinson, 2020) found that 26% of referrals to specialist children’s mental health services were rejected in 2018/19. This amounted to approximately 133,000 children and young people and rejection rates had not improved over the previous four years.

Commenting on the latest NHS figures, co-author of that report Whitney Crenna-Jennings, associate director for wellbeing and inclusion at the EPI, said: "Many children with serious mental health struggles are turned away from specialist services. There is an ongoing urgent need for early intervention services which families everywhere can access.

“While a focus on improving the services that support vulnerable children is welcome, the government must also address drivers of the rise in child vulnerability, including increasing poverty and the cost-of-living crisis. The evidence linking poverty with family conflict, harm to children, special needs and disabilities, and mental ill-health is clear.

“Not doing so will mean that the number of young people who require costly, and less effective, late intervention services will only continue to grow."

  • Children’s Commissioner: Briefing on Children’s Mental Health Services – 2020/2021, February 2022:
  • Crenna-Jennings & Hutchinson: Access to child and adolescent mental health services in 2019, EPI, January 2020:
  • LGA: Debate on special educational needs and children’s mental health services, House of Commons, February 2022:
  • NHS: Mental health services monthly statistics, May 2022:
  • Place2Be: School staff witness an increase in pupil anxiety, low self-esteem and depression, February 2022:
  • Stem4: NHS mental health services turning away children, survey finds, April 2022:

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