- FOIs to NHS trusts in England show some children and young people facing ‘barbaric’ waits of up to 3 days in A&E
- Royal College of Nursing (RCN) and Royal College of Paediatrics and Child Health make joint intervention
Children and young people are being “unforgivably failed” say nursing staff, as new analysis shows around half a million presented to NHS emergency departments in a mental health crisis since 2019, with some now facing waits as long as 3 days before being transferred to a mental health unit.
Overall, waits of 12 hours or more for children in a mental health crisis more than tripled during the same period in NHS trusts in England, the research finds.
It comes just days after the government announced it will develop a new “once-in-a-generation" national strategy for mental health to “drive a fundamental shift towards prevention”.
From Liverpool, on the third day of its annual congress, RCN General Secretary and Chief Executive Professor Nicola Ranger, warns the government’s new strategy will “die on the page if social determinants of mental health are not given parity, not just politically, but in pure investment terms too”.
The RCN is joined by the Royal College of Paediatrics and Child Health (RCPCH) in calling for action from government.
Freedom of information (FOI) requests sent to acute NHS trusts in England revealed that an estimated 500,000 children and young people suffering with mental ill health turned to emergency departments for help since 2019.
The scale of the crisis affecting children with mental ill health is evidence of a “catastrophic system-wide failure”, says Professor Ranger.
The RCN is calling on the government to expand its roll-out of a network of mental health emergency units to protect children in a mental health crisis from “damaging and potentially traumatising” visits to acute A+Es. The units were announced almost a year ago, but the College says they should be rapidly expanded across the country, with too many communities still without safe, dignified places to seek care in a crisis.
The College says the government’s new mental health strategy must not just deliver parity of esteem between mental and physical health needs, but also address the social determinants of mental health in children and young people such as poverty, poor and insecure housing, social isolation, as well as unstable employment.
Since 2021, the number of children and adolescents who have received one assessment or ongoing treatment from mental health services (CAMHS) has risen by a third (649,340 in 2021 to 863,472 in 2025). It is not uncommon for children and young people referred to CAMHS to wait years for treatment.
Meanwhile, RCN analysis of government data shows that for every 2 children living in temporary accommodation 15 years ago, there are now 5, reaching 176,130 by December 2025. Research published by Shelter saw 60% of parents report that living in temporary accommodation had a negative impact on their children’s physical or mental health.
Since 2019, the number of children and young people attending A+Es with mental ill health has increased by an estimated 6% (37,264 to 39,497 across the 70 Trusts that provided data over all years). The problem is spread unevenly across England with some hospitals seeing the number of mental health attendances increase massively.
At University Hospital Birmingham NHS Foundation Trust, which operates three A+Es in the West Midlands, the number of children and young people attending A+E rose by over a third between 2019 and 2025 (1,306 to 1,789).
Meanwhile, University Hospitals Bristol and Weston NHS Foundation Trust, which operates two A+Es in the Bristol area, saw the number of children and young people attending A+E rise by 76% (681 to 1,196).
In the capital, Barts Health NHS Trust saw a 27% jump from 848 to 1,075.
“My job is to look after poorly children but we simply don’t have the capacity or the training to deal with seven or eight mentally ill children a day,” said one senior A+E paediatric nurse in a London hospital. “I so often feel powerless. It is absolutely soul-destroying.”
Another London paediatric A+E nurse said the public “would be shocked” if they knew how many mentally ill children and young people came to emergency departments in distress.
“A+E is just seen as this big receptacle for all children who are dysregulated or in crisis,” she said. “But A+E is not respite for children with mental health concerns. It can often exacerbate their trauma.”
The FOI data also shows a deeply concerning rise in the number of under-18 patients waiting over 12 hours in A+E before being admitted to a mental health unit, increasing from 237 in 2019 to 802 in 2025.
These longer waits - some amounting to over three days - are “extremely distressing” for both patients and nursing staff, said one paediatric A+E nurse in a South of England hospital.
“Long A+E waits for children in mental health crisis are frankly barbaric,” said one paediatric A+E nurse in a London hospital. “It should never happen, but they’re becoming far more normal.”
At East Suffolk and North Essex NHS Foundation Trust, which operates one A+E in Ipswich and another in Colchester, the number of 12hr+ waits nearly tripled between 2019 and 2025 (32 to 91). Meanwhile, at the Royal Berkshire Hospital in Reading, there were 3 12hr+ waits in 2019, rising to 40 in 2025.
One senior paediatric A+E nurse in the South of England said any length of time in “brightly lit and busy” paediatric A+Es was simply wrong. “It is not the right environment for kids in crisis,” she said.
“You can have teenagers in heightened distress, potentially in psychosis, waiting to be seen while one or two year olds are toddling around,” she said. “We’ve had some real near misses. It is utterly unsuitable.”
“The impact these patients have on the department can be massive,” said one paediatric consultant at an A+E in the Midlands. “They are often in distress, and it’s not their fault, but their behaviour can upset other patients and their families. We do our best to support and reassure everyone, but the truth is that an emergency department is not always the best place for them.”
Another A+E paediatric nurse in the South of England expressed her sadness at how her team are forced to increasingly use medication to sedate mentally ill children and young people to manage their behaviour in busy and overcrowded wards.
“It is absolutely heartbreaking for both the patient and staff,” she said. “But often we don’t have a choice.”
“These children just shouldn’t be in A+E,” said another paediatric A+E nurse in the South of England. “We desperately need better funded community services to stop them being there in the first place.”
Professor Nicola Ranger, RCN General Secretary and Chief Executive, said:
“Half a million children and young people attending A+E in a mental health crisis is evidence of a catastrophic system-wide failure. Nursing staff give their all in the most difficult circumstances, but the fact is that busy and stressful A+Es are wholly unsuitable places for anyone in mental distress, let alone vulnerable children.
“It's absolutely vital the government rapidly rolls out mental health emergency departments across the country to put a stop to these damaging and potentially traumatising A+E visits. Children and young people deserve appropriate treatment in a safe and dignified environment.
“But I also want us to fully get a grip on the underlying causes of mental ill health among the young, including poverty, as well as poor and insecure housing .I am clear to ministers that their new strategy will die on the page if social determinants of mental ill health and are not given parity, not just politically, but in pure investment terms too. Children are being unforgivably failed and the time for sticking plasters is over.”
RCPCH Officer for Mental Health, Dr Sam Jones, said:
“Alongside rising levels of poor mental health, the nature of need is changing fast. Problems are more complex and severe, more younger children are affected, and rates of self-harm and eating disorders continue to rise. Yet services remain dangerously underfunded, leaving healthcare professionals unable to meet growing demand.
“This demands urgent, coordinated action across government to ensure earlier and equal access to effective timely support and investment in prevention. Tackling child poverty, improving understanding of children’s mental health, and ensuring families can access the support they need are essential, alongside stronger investment in children’s physical health. Services must also be properly funded so care can be delivered early and effectively.”
ENDSNotes to editors
80 Trusts (64%) responded to the FOI and 45 Trusts failed to provide any response. Based on these responses:
There were over 330,000 reported cases of children and young people (under 18) with mental ill-health presented at A&Es across these trusts from 2019 to 2025 inclusive.
There was an average of over 47,000 presentations each year (across the 80 Trusts), or 613 presentations in each Trust, each year. Latest quarterly A&E attendance data (Jan - Mar 2026) – a measure of Trust size – were used to calculate a figure for all Trusts in England. This took the proportion of the country the FOI respondents covered (approximately two thirds) and, in turn, this figure was used to calculate the national figure. The overall figure is likely to be an under-estimate as some respondents did not provide data for all years.
There are increasing numbers of cases year-on-year waiting for more than 12 hours following a decision to admit; from an estimated 237 to 802 between 2019 to 2025 (+238% increase).
