39% rise in number of children needing help for serious mental health problems

There has been a dramatic rise in the number of children needing treatment for serious mental health problems including eating disorders, figures show.

NHS data analysed by the PA news agency shows a 39% rise in a year in referrals for NHS mental health treatment for under-18s, to more than a million (1,169,515) in 2021/22.

This compares with the previous year 2020/21 – pandemic year – when the figure was 839,570. In 2019/20 there were 850,741 referrals.

The England-wide data includes children who are suicidal, self-harming, suffering serious depression or anxiety, and those with eating disorders.

Meanwhile, NHS Digital data analysed by PA shows hospital admissions for eating disorders are rising among children and young people.

Among under-18s, there were 7,719 admissions in 2021/22, up from 6,079 the previous year and 4,232 in 2019/20 – an 82% rise across two years.

From April to October 2022 – the most recent data available – there were 3,456 admissions, up 38% from 2,508 for the same period in 2019, before the pandemic.

There were 3,011 admissions from April to October 2020, and 4,600 for the same period in 2021 when the full effects of the pandemic were felt.

For people of all ages, including adults, the data suggests 2022/23 could see the highest number of hospital admissions for eating disorders..

From April to October 2022, there were 15,083 admissions, compared with 28,436 for the whole of the previous year (2021/22).

A year earlier there were 23,351 admissions, and in 2019/20 there were 20,650, marking a 38% rise between 2019/20 and 2021/22.

Dr Elaine Lockhart, chairwoman of the child and adolescent psychiatry faculty at the Royal College of Psychiatrists, told PA the rise in referrals for children and young people reflects a “whole range” of illnesses.

She said “specialist services are needing to respond to the most urgent and the most unwell”, including youngsters who have psychosis, suicidal thoughts and severe anxiety disorder.

Dr Lockhart said targets for seeing children urgently with eating disorders were sliding “completely” and more staff were needed.

“I think what’s frustrating for us is if we could see them more quickly and intervene, then the difficulties might not become as severe as they do because they’ve had to wait,” she added.

Dr Lockhart said children and young people’s mental health had been getting worse before the pandemic, with increasing social inequality, austerity and online harm playing a role.

“When the lockdowns and pandemic struck, that really had such a negative effect on a lot of children,” she added.

“Those who had been doing well became vulnerable and those were vulnerable became unwell.

“And part of that was about children themselves feeling very untethered from the day-to-day life that supports them… but also seeing their own parents struggle, and then that collective heightened sense of anxiety and loss of control we all had really affected children.”

Dr Agnes Ayton, chairwmoman of the eating disorders faculty at the college, said patients seen “on the front line… are usually quite severely ill” and services are struggling to meet demand.

She said a number of factors can affect a child’s chance of developing an eating disorder, such as genetics, social media, anxiety (including from the pandemic) and weight-loss advertising.

She told PA: “The numbers, the trends, are going going up. There definitely has been an impact of the pandemic but the trends have been going up since way before then.

“There is no indication that the figures will go down without a strategy that includes prevention, improved treatment, better access to effective inpatient treatment and better research facilities.”

Dr Ayton said the figures on hospital admissions for children and young people were “utterly heart-breaking”, adding: “Without early support eating disorders become much worse and harder to treat, with possible life-altering consequences.

“If the Government and NHS leaders are serious about dealing with this ongoing eating disorders crisis, they must ensure specialist services are supported with the same level of focus given to elective care.”

Tom Madders, director of communications and campaigns at YoungMinds, said the figures were “deeply concerning”, adding: “We know from speaking to young people and our own research that the last year has been one of the most difficult for this age group, emerging from the pandemic to more limited prospects for their futures, coupled with an increase in academic pressure to catch up on lost learning, and the impact of the cost-of-living crisis.

“Sadly, the numbers come as no surprise following a string of similar statistics in recent months underlining the emergency in young people’s mental health.

“The current state of play cannot continue. The Government must get a grip of the situation.”

The data shows that anorexia is the most common eating disorder leading to hospital admission among all ages, with 10,808 admissions in 2021/22.

Bulimia is the next most common, with 5,563, while other eating disorders accounted for 12,893 admissions.

Tom Quinn, director of external affairs at eating disorders charity Beat, described the figures as “extremely concerning”.

He added: “Hospital treatment is usually reserved for those who are most unwell, and so a rise in hospital admissions indicates that young people are not getting local treatment quickly enough, and that their eating disorder may have become more entrenched.

“The Government and NHS must create a plan to fill workforce gaps, which where appropriate should include allocating trained and supervised non-clinical staff.

“More eating disorder training for healthcare and education professionals would also help to spot the signs of eating disorders quickly and help ensure that young people are signposted to support at the earliest opportunity.”

An NSPCC spokesperson said: “These alarming figures are sadly reflected in the conversations we are having through Childline. The service delivers tens of thousands of counselling sessions every year to children and young people who are self-harming, suffering depression or anxiety, experiencing suicidal thoughts and have eating disorders.”

A Department of Health and Social Care spokesman said: “Improving eating disorders services is a key priority and we’re investing £53 million per year in children and young people’s community eating disorder services to increase capacity in 70 community teams across the country.

“We are already investing £2.3 billion a year into mental health services, meaning an additional 345,000 children and young people will be able to access support by 2024 – and we’re aiming to grow the mental health workforce by 27,000 more staff by this time too.”