Referrals to children and young people's mental health services across England crossed the 1 million mark for the first time in the 2024–25 financial year, according to a report published by England's children's commissioner. The figure represents a rise of close to 10% on the previous year and stands at roughly twice the volume recorded in 2018–19, pointing to a sustained and accelerating increase in demand for specialist support among under-18s.
A Threshold Crossed
The symbolic breach of the 1 million referral mark has drawn significant attention from policymakers and children's health advocates. While referral numbers do not map directly onto diagnoses or treatment episodes — a referral may be rejected, redirected, or placed on a waiting list — they are widely used as a leading indicator of population-level need and of the pressure placed on NHS mental health infrastructure.
The children's commissioner's report, cited by The Guardian, frames the data in stark terms. England's children's commissioner, Rachel de Souza, described the situation as a
crisis
and called for a comprehensive overhaul of the state's approach to mental health provision for children and young people.
Six Years of Accelerating Demand
The longer-term trend is particularly striking. Referral volumes in 2024–25 were nearly double those recorded in 2018–19, suggesting the increase predates and extends well beyond any single policy change or external event. Researchers and public health analysts have pointed to a range of potential contributing factors over this period, including the disruption caused by the Covid-19 pandemic, rising rates of social media use among adolescents, economic pressures on families, and reduced access to early-intervention services in schools and community settings.
The near-10% year-on-year rise recorded between 2023–24 and 2024–25 indicates that demand has not plateaued following the post-pandemic period, as some had anticipated. Instead, the upward trajectory appears to have continued at pace.
What the Referral Data Does and Does Not Show
It is worth noting what the referral figures capture and what they do not. A referral to a children and young people's mental health service (CYPMHS, sometimes referred to as CAMHS) is initiated by a professional — a GP, school nurse, or social worker, for example — and does not guarantee that a child will receive treatment. Historically, a substantial proportion of referrals in England have not met the threshold for acceptance into specialist services, meaning children are either turned away or directed toward lower-intensity support.
This means the 1 million figure may, in some respects, understate the scale of unmet need. Children whose difficulties do not meet referral criteria, or whose families do not engage with formal pathways, would not appear in this data at all. Equally, a rise in referrals can partly reflect increased awareness and reduced stigma — factors that might lead more professionals and families to seek help earlier — rather than a straightforward deterioration in population mental health.
Nevertheless, the scale and consistency of the increase has led the children's commissioner to characterise the situation in terms that go beyond routine service pressure.
Calls for Systemic Reform
Rachel de Souza's call for an overhaul of state support structures reflects a broader debate about whether the current model of children's mental health provision in England is fit for purpose. Critics of the existing system have long argued that the binary between specialist CAMHS and universal services such as schools leaves a large gap in the middle, where children with moderate but significant difficulties receive little or no support.
Proposals that have circulated in policy discussions include expanding mental health support teams embedded in schools, increasing the number of community-based early intervention hubs, and reforming the referral and triage processes that currently exclude a high proportion of children who seek help. Whether the government's response to the commissioner's report will translate into additional funding or structural reform remains to be seen.
Broader Context
England is not alone in recording increased demand for children's mental health services. Similar trends have been documented across a number of high-income countries over the past decade, with particular concern focused on rates of anxiety, depression, and self-harm among adolescents. International data published in recent years by bodies including the World Health Organization have highlighted adolescent mental health as a growing public health priority.
Within England, NHS data published in previous years has shown that waiting times for CAMHS assessment have lengthened considerably, and that workforce shortages in child and adolescent psychiatry and psychology have constrained the system's capacity to respond to rising referral volumes. The children's commissioner's report adds a further layer of evidence to that picture.
Key Figures at a Glance
- 1 million+ — children referred to mental health services in England in 2024–25, the first time this level has been reached
- ~10% — year-on-year increase in referrals compared with 2023–24
- ~2× — the 2024–25 referral total relative to the 2018–19 baseline
The children's commissioner's report is available via The Guardian's coverage of the findings. Further detail on the methodology and service-level breakdowns is expected to be published alongside the full report.