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One in four children ‘rejected by mental health services, despite extra funding’

Rise in teenage girls with eating disorders

Over a quarter (26%) of children referred to specialist mental health services in England were rejected in 2018/19, according to a report from the Education Policy Institute.

This amounts to an estimated 132,700 children – including those who have self-harmed, have an eating disorder, or who have experienced abuse – being denied access to treatment, it said.

The report also found there has been no improvement in rejection rates over the last four years, despite an extra £1.4bn being committed to services from 2015/16 to 2020/21.

The institute’s annual report found referrals were most commonly rejected because providers considered young people’s conditions to be unsuitable for treatment, or because they did not meet the eligibility criteria or age specification for the service.

This raises concerns that there are a growing number of children and young people with complex needs who do not fit clearly into diagnostic boxes, the report said.

It also found a widespread variation in rejection rates across the country. In London, 17% of referrals were rejected, while in the south of England, rates were as high as 28%.

The findings echo those of a recent investigation by Pulse, which revealed the increasing difficulties GPs face in getting their child referrals accepted by NHS mental health trusts.

According to data collected by Pulse through freedom of information (FOI)  requests, just one in five trusts accept referrals for children with all severities of mental health conditions.

According to the Education Policy Institute, for those children who do manage to access mental health services, there was still an average wait of two months (56 days) to begin treatment in 2019. This is double the Government’s proposed four-week target, which is unlikely to be met by 2022/23, it said.

Data from 45 mental health providers analysed by the institute also showed that the national average maximum waiting times have fallen over time, but remain high – at 335 days for assessment and 451 for treatment.

The report concluded the system was failing to meet need across the country and said it remains unclear what support is available for the children whose referrals are rejected.

Whitney Crenna-Jennings, senior researcher at the Education Policy Institute, said denying children access to mental health treatment would have ‘major repercussions’.

She said: ‘The Government should move towards a preventative approach to dealing with mental health problems, in order to tackle the rising demand for services. The evidence is clear that mental health problems should with be dealt with early on in a child’s life, with high quality support available across health, education and local authority services.’

Commenting on the report findings, Vicki Nash, head of policy and campaigns at charity, said it was ‘deeply concerning’ that thousands of young people were not getting help for serious mental health problems.

She added: ‘The Government has responded with investment, but something isn’t working when thousands of young people are still being rejected for treatment.

‘We know services are struggling to cope with the increasing numbers of people needing support but no young person should face being turned away by the NHS. As demand grows, under-supported staff are also leaving in droves, impacting young people’s likelihood of being able to access services they desperately need.’

An NHS England spokesperson said: ‘The NHS is actually ahead of its target on ensuring as many children as possible receive mental health care – seeing an extra 53,000 children, teenagers and young adults last year, a 14% increase on the year before and 22% more staff in services than five years ago, against a backdrop of rising referrals.’

They added that the analysis in the institute’s report was ‘flawed’ and that it did not accurately reflect ‘how modern services for families operate in partnership with other agencies’.

‘The assumption that every referral should get NHS treatment when more appropriate support might be provided elsewhere – for example from schools and local authorities – is wrong,’ said the spokesperson.


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