Six-Year-Olds Now Wait Overnight in A&E for Mental Care

In 2025, 75,491 children aged 6 to 17 attended English A&E units with a recorded mental health concern. That is up 36% from 55,525 in 2019, far ahead of the just over 8% rise in all A&E visits over the same stretch.

The steepest climb was among children aged six to nine. New youth hubs start at 10, and school mental health teams still reach secondary pupils first, so the youngest children in crisis still spend the night in a noisy emergency bay.

Mental Health Visits to A&E Are Up 36%

The Royal College of Paediatrics and Child Health analysed NHS England figures released under the Freedom of Information Act. The count covers self-harm, eating disorders and emotional crisis among six- to 17-year-olds, including children brought in by families, carers and police.

Some of those children become aggressive or hard to hold in a bay built for broken bones and breathing trouble. Dr Mark Buchanan, of the Royal College of Emergency Medicine, said they are ending up in A&E by “default,” and that they deserve care in settings designed for their needs.

THE NHS ENGLAND COUNT

A separate Freedom of Information round by the Royal College of Nursing, answered by 80 of 125 acute trusts, produced a broader estimate of about half a million under-18 mental-health presentations from 2019 through 2025. Nicola Ranger, the college’s general secretary, called that “a catastrophic system-wide failure.” Those trust returns are a different cut from the NHS England series, and they should not be added together.

Six- to Nine-Year-Olds Are Rising Fastest

Among six- to nine-year-olds, visits rose from 3,870 to 6,269, a 62% jump and the fastest of any age band in the analysis. That is 2,399 extra primary-age children in a single year, in departments that were never staffed as overnight mental-health wards.

The college said the pattern is “particularly worrying given the vulnerable nature of young children’s neurodevelopment and the potential of suffering for those children longer term without early intervention.” This is not a tiny sliver of illness suddenly appearing in A&E. NHS Digital’s 2023 survey already put a probable mental disorder in 15.7% of eight- to 10-year-olds, and in 20.3% of children aged 8 to 16, up from 12.5% in 2017.

Rates then hold rather than fade. Among 11- to 16-year-olds the 2023 figure was 22.6%. The college also notes that more than half of mental health problems in adulthood start by the age of 14, which is why a six-year-old who only meets a doctor at hour 12 in A&E is already late.

Why Primary-Age Children Still Land in A&E?

They land there because community crisis care is thin, and because the people who love them have already tried the other doors. Dr Samantha Jones, a consultant in paediatric emergency medicine and the college’s officer for mental health, has worked in children’s emergency departments for 25 years. On the college’s State of Child Health pages she describes presentations that are younger in age and more complex, often neurodivergent or still waiting for an assessment, and sometimes brought in after a care placement has broken down.

CYP and families turn to health services as a place of safety, but often also as a last resort. They report having tried to get support elsewhere, not feeling listened to or understood, and attend in despair. Their children are often on waiting lists or are known to services, but support feels insufficient or too late.

Dr Samantha Jones, consultant in paediatric emergency medicine and RCPCH officer for mental health, State of Child Health 2026

Physical-health trained staff, she said, feel underprepared for the numbers and the complexity, and unable to keep patients safe in rooms that were not built for this work. Families arrive frustrated and at breaking point. The college’s own training push, including the Children and Young People’s Acute Psychiatric and Psychosocial Emergencies course, is an attempt to catch a workforce up with a caseload it did not used to see at this age.

A NIHR-funded study in Lancet Child and Adolescent Health had already shown a 65% rise in ward admissions for mental health concerns among five- to 18-year-olds between 2012 and 2022, from 24,198 to 39,925, against a 10.1% rise in all-cause admissions. The steepest ward increases were in girls aged 11 to 15 and in eating disorders. The new A&E series moves the same pressure down the age range, into the years before most of the new community kit even applies.

Hundreds Now Wait More Than 3 Days

Once a child is through the door, the wait itself becomes part of the harm. 6,235 children and young people stayed more than 12 hours in 2025, up from 1,964 in 2019, a 217% rise. That is about 8 in every 100 of the mental-health visits. Among them, 338 were still there after 72 hours, up from 55, a 514% rise.

Gemma Byrne, of the mental health charity Mind, said A&E can be a frightening environment for anyone in crisis, “let alone a child,” and that more than 12 hours there is “simply unacceptable.” Jones put the same point in college language: emergency departments are a vital safety net, but they were never designed as a place where children in mental health crisis wait for days at a time.

The nursing college’s trust-level FOI, which tracked a narrower group waiting to be moved into a mental-health unit, found those 12-hour waits rose from 237 in 2019 to 802 in 2025. Some children were still there after three days. Busy lights, alarms and strangers are a poor substitute for a quiet room and a clinician who knows the child’s plan. Jones has seen local CAMHS teams offer home triage within two hours for lower-level need, which keeps some children out of the bay. That is the exception, not the map.

Help Still Starts Only When Children Are Unwell Enough

Byrne said many mental health services only step in when young people are considered “unwell enough” to qualify, and that this is not working. The wait behind that gate is now measured in seasons, not days.

THE WAIT FOR COMMUNITY CARE

• Median CAMHS wait: YoungMinds’ reading of NHS England figures put the median wait from referral to support at 304 days between September and November 2025, up 28 days from 276 a year earlier, and above 300 days for a fourth stretch running.
• Longest waits: In the worst cases young people waited 976 days, more than two and a half years, before they got help.
• Open children’s caseload: 527,972 people had an open referral with children and young people’s mental health services at the end of May 2026.
• ADHD assessments: NHS England monitoring cited in Professor Peter Fonagy’s interim review showed children and young people waiting for an ADHD assessment rose from about 21,000 in April 2019 to about 270,000 by December 2025.

YoungMinds’ parents helpline handled 13,836 calls, emails and chats in 2025. Anxiety, school problems and anger topped the list, with autism close behind, which matches what Jones sees in the bay: children who are already known to services, or stuck on a list, arriving only when the house can no longer hold the night. The college also records that about 70% of children with autism have at least one other mental health condition, so a neurodevelopmental wait and a crisis visit are often the same child on two clocks.

Jones told the college that demand for assessment now outstrips capacity, which raises family stress and, in some cases, leads to family crisis and breakdown. Mental Health Champions in acute trusts had been a way to spread better local practice; funding for that role has ceased, even as the A&E numbers keep rising.

School Teams Reach Secondary Pupils First

Ministers point to Mental Health Support Teams in schools as the early door. By 2025-26 those teams reached 5.8 million pupils and learners, about 60% of the total, in 11,800 schools and colleges, according to Department for Education coverage figures. A June 2026 government update put the pupil count at nearly six million, about 800,000 more than the year before, with nearly 80% of secondary schools covered and a promise of every school and college by the end of 2029.

The split by setting is the part that matches the A&E age band.

WHERE SCHOOL TEAMS ACTUALLY ARE

Nine in 10 schools and colleges in the government update said the teams were improving children’s mental health, and seven in 10 reported better attendance. That is real help for the pupils who have a team. It is also a map that still leaves half of primary schools without one, in the same years where A&E mental-health visits rose 62%.

Access inside school has not kept pace with need even where a team exists. Among children and young people with a probable mental disorder, the share able to get support through school fell from 59.8% in 2022 to 53.1% in 2023. Children make up 25% of the population and receive 11% of healthcare funding, the paediatric college has warned, and overall child A&E visits rose from 5.4 million in 2018-19 to more than 6.3 million in 2024-25. Mental-health nights are a slice of that crush, not a separate queue with its own rooms.

The New Hubs Open at Age 10

The other doors being built this year have the same age line. Young Futures Hubs are spaces for 10 to 18-year-olds, 50 of them by March 2029, with the first eight in Birmingham, Brighton and Hove, Bristol, County Durham, Leeds, Manchester, Nottingham and Tower Hamlets. Early support hubs, which take drop-in mental health work without a referral, are for ages 11 to 25; a February 2026 boost of £7 million was meant to fund 10,000 extra sessions across 24 existing sites.

On 5 August 2026 the government announced £343 million for 159 new NHS mental health centres: 100 community walk-in sites and 59 dedicated mental health emergency departments. There are 6 community centres and 23 mental health emergency departments now. The new round more than doubles the emergency units to 82, with the first due from autumn 2026 and more from March 2027. Fifty-seven will be new buildings and 102 conversions, some in libraries, banks and high-street sites. Health and Social Care Secretary Yvette Cooper said people in crisis who are medically fit should get same-day specialist care “in the right setting” rather than a long wait in a busy A&E.

WHAT MINISTERS HAVE OPENED

• School teams: 5.8 million pupils on paper, full national cover promised by 2029, with primary coverage still at 56% of pupils.
• Young Futures Hubs: 50 sites for ages 10 to 18 by March 2029, eight early sites already named, backed by a £70 million local programme.
• Early support hubs: 24 drop-in sites for ages 11 to 25, plus 10,000 extra sessions from a £7 million top-up.
• New NHS centres: 100 walk-in community centres and 59 mental health emergency departments from autumn, £156 million for the emergency units and £187 million for the community sites.

Lynn Perry, chief executive of Barnardo’s, welcomed the neighbourhood centres and said she hoped the needs of children and young people would be “placed right at the heart.” That hope is the tell. The published list of emergency units is built around general hospitals and adult mental-health sites. A six-year-old in crisis this winter still has the same last door as last winter.

Prime Minister Andy Burnham said thousands of people wait months for help, then find the only door open is a busy A&E. A Department of Health and Social Care spokesman, asked about the new paediatric figures, pointed to school teams and “more than 150” community hubs in places such as banks and libraries, and said no child should have to reach crisis point before getting support. The cross-government mental health strategy those hubs are meant to serve is still forthcoming, and will draw on Fonagy’s review of prevalence, ADHD and autism. Claire Evans, of the children’s charity Anna Freud, said that strategy must place children at its heart and speed up community support.

Until those rooms exist for primary age, the 6,269 six- to nine-year-olds who already came through A&E in 2025 remain the group with the fewest alternatives. Jones called it a national crisis that will only get worse without urgent intervention. The first of the new emergency departments are due this autumn. The age on the door of the youth hubs is still 10.

Disclaimer: This article is news reporting and analysis of NHS figures, college statements and government announcements, and it is for information only. It is not medical, mental-health or safeguarding advice, and it cannot tell a parent or carer what to do in a crisis. Anyone worried about a child’s safety or mental health should contact a qualified professional such as a GP, NHS 111, a CAMHS crisis line, or emergency services if there is immediate risk. Figures and service plans here reflect the sources as of 2 September 2026 and may change as later data and the promised mental health strategy appear.