Around 500,000 children and young people under the age of 18 have attended A&E in a mental health crisis since 2019, with some facing waits of up to three days before being transferred to a mental health unit, according to new analysis from the Royal College of Nursing (RCN).
Freedom of Information (FOI) requests sent by the RCN to acute trusts in England show that waits of 12 hours or more for children in mental health crisis have more than tripled over the same period, highlighting mounting pressure on emergency departments and mental health services.
The findings come just days after the UK government announced plans to develop a new “once‑in‑a‑generation” national mental health strategy, intended to “drive a fundamental shift towards prevention”.
Speaking on the third day of the RCN’s annual Congress, Professor Nicola Ranger, RCN General Secretary and Chief Executive, said the new strategy must directly address the social determinants of mental health affecting children and young people, including poverty, insecure housing, social isolation and unstable employment.
She warned that without serious investment, the strategy risks failing to deliver meaningful change.
Nicola said the strategy would “die on the page if social determinants of mental health are not given parity, not just politically, but in pure investment terms too”. Addressing the scale of the problem, she 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.”
Alongside the Royal College of Paediatrics and Child Health (RCPCH), the RCN is calling on the government to expand the roll‑out of a national network of mental health emergency units, designed specifically to support children and young people in crisis.
Nicola added:
“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."
The RCN says the figures underline the urgent need for system‑wide reform, with investment not only in specialist mental health services, but also in prevention, early intervention and wider social policy, to reduce the number of children reaching crisis point.
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