As a young Emergency Department doctor, I developed a spiel for the kids who came in with mental health problems. ‘I do the easy bit,’ I told them. ‘I deal with the physical. Let’s get that sorted first and then I’ll put you in touch with the people who’ll do the hard bit, the important bit, and who’ll help make life brighter for you.’
Often I told them this as I stitched up gashes they’d made in their arms or legs or chests. Frequently the gaping skin, parted to reveal glistening fat or muscle beneath, lay beside rows of older scars. Sometimes there’d be no scars save their despair, and I’d be taking blood to check on their overdose. Other times, more rarely, there’d really be nothing physical at all, and my only job was to confirm that before referring them on.
That was over 20 years ago, and somehow mental illness in children has grown worse. A Welsh study tracked children through their whole childhoods: of those turning 18 in 2009, one in 17 had used Child and Adolescent Mental Health Services (CAMHS); of those turning 18 in 2023, one in five. NHS England data suggest this is not merely increased help-seeking: mental disorders themselves have become more common.
The Royal College of Paediatrics and Child Health (RCPCH) has now released the results of a freedom of information request to NHS England. Between 2019 and 2025, there was a 36 per cent rise in 6-to-17-year-olds attending A&E with mental health problems; among six-to-nine-year-olds, 62 per cent. The number spending over 12 hours in A&E rose 217 per cent, and 338 children spent more than three days there. I spend much of my professional life in these places, and after three days I’d lose sanity as well as hope. The College wants a strategy, but I’m not sure that’s enough.
