10th January 2020

Access to child and adolescent mental health services in 2019

The Education Policy Institute (EPI) has published its Annual Report on access to child and adolescent mental health services (CAMHS). 

The study examines access to specialist services, waiting times for treatment, and provision for the most vulnerable children in England.

The research is based on new data obtained using freedom of information (FOI) requests to mental health providers and local authorities over the course of a year. This data is not published by the NHS.

The majority of lifelong mental health problems develop early on, during childhood or adolescence. The wider economic costs of mental ill health in England are vast, estimated at £105bn each year.

You can download the full report here

Key findings


Access to mental health services for children and young people

  • Over a quarter (26%) of referrals to specialist children’s mental health services were rejected in 2018-2019. This amounts to approximately 133,000 children and young people.
  • Rejection rates have not improved over the last four years, despite an extra £1.4bn committed from 2015-16 to 2020-21.
  • There is considerable regional variation in England. On average, providers in London rejected 17% of referrals, compared to 28% in the South, the Midlands and the East, and 22% in the North.
  • The most common reason given by providers for rejections included children’s conditions not being suitable for treatment, or because conditions did not meet eligibility criteria.

Waiting times for mental health treatment

  • While nationally, the average median waiting time to begin treatment has fallen by 11 days since 2015, children still waited an average of two months (56 days) to begin treatment in 2019 – double the government’s four-week target. The government is unlikely to meet its target of four weeks by 2022-23.
  • The longest median waiting times to receive treatment were in London (65 days) and the shortest in the Midlands and East of England (49 days). This is likely related to the high number of referrals accepted for treatment in London.
  • Beyond regional averages, there are great disparities across local CAMHS providerswith many children facing unacceptably long waiting times. Median waiting times for treatment across mental health providers varied from just 1 day to 6 months (182 days).

Providers in England with the longest median waiting times for mental health treatment are:

  • West London Mental Health Trust – 182 days
  • South Tyneside and Sunderland – 129 days
  • Alder Hey – 124 days
  • Leeds Community Healthcare – 117 days
  • Northumberland, Tyne and Wear – 116 days
  • Birmingham Women’s and Children’s Hospital – 112 days
  • Sussex Partnership – 100 days
  • East London – 90 days
  • Birmingham and Solihull – 87 days
  • Cambridgeshire and Peterborough – 82 days

Mental health support for young people most in need

  • Local commissioners and providers of mental health support services often fail to engage with the most vulnerable children and families. Local provision is patchy and lacks accountability, being dispersed across several organisations. Support for children with less acute, common mental health conditions, such as conduct disorders, as well as those in social care, is insufficient.
  • There is also a lack of support among LAs for those transitioning from child to adult mental health services. FOI responses show that only a minority of LAs have specific services dedicated to supporting this important transition. 
  • Government plans to boost the provision of mental health support in schools are a positive step for intervening in mental health problems earlier on, and supporting some of the most vulnerable children. However, they will not be rolled out nationally until 2022-23, and there is likely to be wide geographic variation in how they operate.

All mental health providers should be required to report regularly on their services

  • There are multiple flaws in the current system for reporting and disclosing basic data on CAMHS in England, raising serious questions about transparency and accountability.
  • Providers continue to give inadequate information on access to treatment, obscuring our understanding of the state of services and ability to monitor progress.  
  • A universal system for reporting data on access to CAMHS, including a clear definition of children who are eligible for treatment, is urgently required. Failure to introduce stronger accountability measures may hinder the government’s plans to improve services.