Around 500,000 children and young people in England have attended emergency departments in mental health crisis since 2019, new research has suggested. Nurses said that A&E is “not the right environment for kids in crisis”, with one speaking of “some real near misses” as distressed teenage patients wait to be seen in the same area as babies.
There has also been a rise in the number of youngsters waiting more than 12 hours in A&E before being admitted to a mental health unit, according to the Royal College of Nursing (RCN). The figures are evidence of a “catastrophic system-wide failure”, the union’s general secretary and chief executive Professor Nicola Ranger said.
Research released as part of the RCN’s annual congress in Liverpool shows it submitted freedom of information (FOI) requests to acute NHS trusts in England, with 80 (64%) providing data. Figures show there were more than 330,000 reported cases of under-18s attending A&E with poor mental health from 2019 to 2025, an average of 47,000 per year. The RCN calculated the national figure to be around 500,000, although the union highlighted the true number is likely to be higher as some trusts did not provide data for all years.
One senior A&E paediatric nurse in a London hospital told the RCN: “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. I so often feel powerless. It is absolutely soul-destroying.”
A senior paediatric A&E nurse in the South of England said emergency departments are “not the right environment for kids in crisis”. “You can have teenagers in heightened distress, potentially in psychosis, waiting to be seen while one or two-year-olds are toddling around,” they said. “We’ve had some real near misses. It is utterly unsuitable.”
The FOI data also showed a rise in children and young people in mental health crisis waiting more than 12 hours in A&E, with the number of cases increasing from 237 in 2019 to 802 in 2025. A paediatric consultant in the Midlands said these patients can have a “massive” impact on the department as they are often in distress, with their behaviour upsetting patients and families.
The RCN is calling for the rapid expansion of special mental health A&E centres which were announced by NHS England last year. Prof Ranger 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 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.”
It is estimated that around one in five eight to 25-year-olds have mental health problems such as anxiety and depression. Dr Sam Jones, officer for mental health at the Royal College of Paediatrics and Child Health, 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, co-ordinated 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.”
Prof Ranger also urged the Government to “fully get a grip” on the causes of poor mental health in children and young people. “I am clear to ministers that their new strategy will die on the page if social determinants of mental ill health are not given parity, not just politically, but in pure investment terms too,” she said. “Children are being unforgivably failed and the time for sticking plasters is over.”
A Government spokesperson said: “Too many children and young people are reaching crisis point with their mental health, and far too often they are ending up in A&E as a result – that must change. No one should be forced to wait 12 hours for care, but the issue goes beyond waits alone – we need to make sure every child gets the right support much earlier, before problems escalate. That’s why we will publish a new mental health strategy this year, focused on earlier intervention and faster access, backed by more staff, more community support and new facilities so young people can get help closer to home. We are also increasing inpatient capacity, delivering 8,500 more mental health workers three years ahead of schedule, and investing more than £400 million in specialist mental health departments, centres and wider capital projects.”
