Across England, emergency departments have quietly become the default refuge for children in psychological crisis — not by design, but by default. Between 2019 and 2025, A&E attendances by children aged six to seventeen in acute mental distress rose by 36 percent, reaching over 75,000 cases, while the broader safety net of community mental health services has failed to keep pace. The pattern speaks to something deeper than a healthcare statistic: a society still struggling to meet the inner lives of its youngest members before those lives reach a breaking point.
Children's mental health crisis strains A&E as attendances surge 36%
Thousands of children and young people in mental health distress are experiencing prolonged waits in inappropriate emergency settings, with over 6,200 waiting more than 12 hours.
Behind every figure is a child in distress and a family with nowhere else to turn.
Mark
So we're talking about a 36 percent increase in six years. That's a real jump. But I want to know: is this because more children are actually in crisis, or because families are using A&E differently now?
Mimi
The data suggests both things are happening. The increase far outpaces overall A&E growth, which was only 8 percent. So it's not just that emergency departments are busier across the board. Something specific is driving children with mental health needs to show up there.
Luke
But we should be careful here. The Royal College analysis is based on Freedom of Information requests to NHS England. That's solid sourcing, but it's counting attendances, not unique children. One child could show up multiple times. We don't know from this data whether we have more children in crisis or the same children in crisis more often.
Mark
Fair point. So what about the waiting times? Over 12 hours seems brutal.
Mimi
More than 6,200 children waited that long in 2025. That's 8 percent of the total. A&E is not designed for mental health care—it's designed for acute physical injury. A child sitting there for 12 hours in distress is in the wrong environment entirely.
Luke
And we should note: the source doesn't tell us what happens after those 12 hours. Do they get admitted? Discharged? Referred elsewhere? The waiting time is documented, but the outcome isn't.
Mark
What about the youngest kids? The source mentions six-year-olds.
Mimi
Yes, some of the biggest increases are in children aged six to nine. A six-year-old in emotional crisis in an A&E waiting room—that's a child who should be getting support much earlier, in school or in the community.
Luke
The source doesn't give us the absolute numbers for that age group, though. It says "some of the biggest rises," which is directional but not precise. We know the overall picture, but the granular breakdown by age isn't there.
Mark
So what's the actual solution people are proposing?
Mimi
The main one is community-based crisis support and early intervention. Youth hubs that combine mental health with other services. Mental health teams in schools. The idea is to catch problems before they become crises.
Luke
And the government says it's already doing some of this—150 new mental health hubs, teams in schools. But the data shows the crisis is accelerating faster than these interventions are rolling out. So the question is whether the pace of expansion matches the pace of need.
Mark
When does the new mental health strategy come out?
Mimi
The government said "later in the summer," but the article was published in early September, so that timing may have shifted. We don't have confirmation of when it actually lands.
Luke
Exactly. The government is promising a strategy, but the crisis is happening now. Children are waiting 12 hours in A&E today.
El Pulso
- Children as young as six are arriving at emergency departments in states of acute distress — self-harming, refusing food, or overwhelmed by emotional crisis — in environments built for broken bones, not broken spirits.
- Over 6,200 children waited more than 12 hours in A&E during a mental health crisis, sitting under fluorescent lights amid the noise of acute medicine, with staff not trained to meet their needs.
- The surge — 36% growth against just 8% for overall A&E attendance — signals that the mental health crisis among young people is accelerating far faster than the system designed to catch them.
- Medical leaders are clear: A&E has not failed these children — the community services that should have reached them first have, leaving emergency departments as an unintended last resort.
- The government points to school-based mental health teams and 150 new community hubs as early progress, with a national mental health strategy expected this summer — but experts warn the pace of change must match the scale of the crisis.
Across England, emergency departments have quietly become the default refuge for children in psychological crisis — not by design, but by default. Between 2019 and 2025, A&E attendances by children aged six to seventeen in acute mental distress rose by 36 percent, reaching over 75,000 cases, while the broader safety net of community mental health services has failed to keep pace. The pattern speaks to something deeper than a healthcare statistic: a society still struggling to meet the inner lives of its youngest members before those lives reach a breaking point.
England's emergency departments were never designed to be sanctuaries for children in psychological crisis. Yet that is precisely what they have become. Between 2019 and 2025, the number of six to seventeen-year-olds arriving at A&E in acute mental distress — presenting with self-harm, eating disorders, or severe emotional turmoil — rose by 36 percent, reaching 75,491 cases in 2025. The youngest children, aged six to nine, have seen some of the steepest increases. This surge dwarfs the 8 percent overall growth in A&E attendance across the same period.
The children who arrive come through different doors. Some are brought by families who have run out of options. Others arrive with police. Many are in states of acute distress, and once inside, they wait — often for more than 12 hours — in environments built for physical illness, surrounded by staff not trained in psychological crisis care. More than 6,200 children experienced waits of that length in a single year.
Medical leaders are unambiguous about the cause. Dr. Sam Jones of the Royal College of Paediatrics and Child Health described each statistic as a child in distress and a family with nowhere else to turn. Dr. Mark Buchanan of the Royal College of Emergency Medicine called the pattern one of default: children end up in A&E not because it is appropriate, but because alternatives are absent or unreachable. The gap is in the community, where many areas lack crisis support outside hospital walls and where mental health services often require young people to be severely unwell before they qualify for help — meaning early intervention is missed and crises deepen.
Proposed solutions include expanding youth hubs — community spaces offering mental health support alongside everyday activities — that do not require a crisis as the entry point. The government has pointed to school-based mental health teams and over 150 new community hubs as signs of progress, and a new national mental health strategy is expected later this summer. Experts from organisations including Anna Freud are urging that strategy to place children at its centre. The question that remains is whether the scale of investment will match the scale of need — or whether emergency departments will continue absorbing a burden they were never built to bear.
England's emergency departments have become an unintended refuge for children in mental health crisis, a pattern that has accelerated sharply over the past six years. Between 2019 and 2025, the number of six to seventeen-year-olds arriving at A&E units in significant distress—presenting with self-harm, eating disorders, or acute emotional turmoil—jumped by 36 percent, according to analysis by the Royal College of Paediatrics and Child Health. The figures are stark: 75,491 such attendances in 2025, up from 55,525 in 2019. The youngest children, aged six to nine, have driven some of the steepest increases. This surge far outpaces the overall rise in A&E visits, which grew by just over 8 percent in the same period, suggesting that the mental health crisis among young people is accelerating faster than emergency medicine as a whole.
The children arriving at these departments come through different doors. Some are brought by families and carers who have exhausted other options. Others arrive with police. Many are in states of acute distress—some become aggressive or display challenging behavior that emergency staff are not trained to manage. Once there, they wait. More than 6,200 children, roughly 8 percent of those presenting with mental health concerns, spent over 12 hours in A&E. These are not brief assessments. These are children sitting in fluorescent-lit waiting areas, surrounded by the machinery of acute medicine, in environments designed for physical injury and acute illness, not psychological crisis.
The fundamental problem, according to medical leaders, is not that A&E has failed these children but that the system has failed them first. Dr. Sam Jones, the Royal College of Paediatrics and Child Health's officer for mental health, framed it plainly: behind each statistic is a child in distress and a family that did not know where else to go. Emergency departments were never built to be holding spaces for young people in mental health crisis. They are a safety net, yes, but a safety net should not become a primary shelter. Without urgent intervention, Jones warned, the situation will worsen. Dr. Mark Buchanan of the Royal College of Emergency Medicine described the pattern as one of default—children and young people with mental health needs ending up in A&E not because it is appropriate but because alternatives do not exist or are inaccessible.
The gap is in the community. Many parts of England lack adequate crisis support outside hospital walls. Mental health services often operate on a threshold model: young people must be deemed "unwell enough" to qualify for help, meaning early intervention is missed and crises deepen. Gemma Byrne of the mental health charity Mind called the experience of spending more than 12 hours in A&E during a mental health crisis simply unacceptable, particularly for children. She pointed to the failure of early support and argued that the system waits too long to intervene. One proposed solution gaining traction is the expansion of youth hubs—community spaces that bring together mental health support alongside employment, sports, and volunteering opportunities, creating entry points that do not require a crisis to access.
The government has acknowledged the problem. A Department of Health and Social Care spokesman noted that improvements are already underway: mental health teams are being placed in schools, and more than 150 new mental health hubs have opened in community locations including banks and libraries. The department emphasized that no child should have to reach crisis point before receiving support. A new mental health strategy is planned for publication later in the summer, and experts from organizations including Anna Freud are calling for it to place children at its center, accelerating investment in accessible, community-based care. The question now is whether policy will match the scale of the crisis. The numbers suggest that without significant expansion of services outside hospital walls, A&E departments will continue to absorb young people in distress—a role they were never designed to fill.
Citas Notables
Emergency departments are a vital safety net, but they were never designed to be a place where children in mental health crisis wait for days at a time. This is a national crisis that will only get worse without urgent intervention.— Dr. Sam Jones, Royal College of Paediatrics and Child Health
A&E can be a frightening environment for anyone in mental health crisis, let alone a child. Making them spend more than 12 hours there is simply unacceptable.— Gemma Byrne, Mind charity
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