More children have mental health referrals closed without treatment, report finds

The proportion of children with mental health issues who had their referrals closed without receiving treatment rose for the first time in five years in 2021/22 – with waiting times also rising by a quarter. 

A new report by the Office of the Children’s Commissioner for England found that in 2021/22, 32% of children who were referred to NHS children’s mental health services (CYPMHS) did not receive treatment, compared to 24% in 2020/21, 27% in 2019/20 and 36% in 2018-19.

The report identified significant differences across the country in how many children’s referrals were closed without treatment, from 5% of referrals in NHS East Sussex to 50% in NHS North Cumbria.

Furthermore, the average waiting time between a child being referred to CYPMHS and starting treatment rose from 32 days in 2020/21 to 40 days in 2021/22. The average waiting time for children to enter treatment – defined as having two ‘contacts’ with CYPMHS – varies from 13 days in NHS Leicester City to as long as 80 days in NHS Sunderland.

Of the 1.4 million children estimated to have a mental health disorder, less than half (48%) received at least one contact with CYPMHS and 34% received at least two contacts.

Spending on children’s mental health services has increased every year since 2017/18 after adjusting for inflation. Local NHS bodies spent £927m on CYPMHS in 2021/22, equal to one percent of the total budget allocated to them. This compares to £869m in 2020/21 – an increase of 7% in real terms.

In a foreword to the report, Children’s Commissioner Dame Rachel de Souza said: ‘This data is the first available since services were widely re-opened after the pandemic, and shows a surging demand for help.

‘The welcome progress that has been made in recent years on improving children’s access to the right support is struggling to keep up with this demand – with waiting times increasing in the first time in years. It is vital that this support is made available because to allow children the chance to recover, and go on to achieve all that they want to, but also because without support things can end up in crisis.

‘Alongside the data, my team have spoken to children living in mental health inpatient settings who say time and again that if only the right help had been there earlier on, they wouldn’t have ended up in hospital. But too many children still are ending up in hospital, and again there seems to be a particular issue for older teenage girls. 71% of detentions of children under the Mental Health Act are of girls.’

The report also found that an increasing number of children, many of whom have mental health difficulties but are not admitted to hospital, are being deprived of their liberty in other settings. The report said these children did not appear in official statistics, but that over ten times as many children are being deprived of liberty in this way in 2023 as in 2017-18.

Photo by Chinh Le Duc