Even for those who see anxious children in the NHS every day, the figures are staggering.
“It’s absolutely shocking,” says a doctor who works in a children’s mental health service in the north of England. “Obviously demand is increasing, but when you see these figures in black and white… it’s absolutely shocking.”
A Guardian investigation published on Tuesday found that the number of children being referred to NHS mental health services in England for anxiety disorders has reached a record high.
In 2023-2024, 204,526 children were referred to mental health services with anxiety as the main cause.
Nearly twice as many organisations (171) submitted data last year compared with seven years earlier (62), but the rise in referrals is still staggering: just 3,879 referrals were made in 2016-17, according to an analysis of NHS data by the Guardian.
“The steep rise in the number of young people suffering from mental health problems is one of the biggest social issues of our time,” said Laura Bunt, chief executive of children’s mental health charity YoungMinds.
These figures highlight the large number of anxious children who often lack support and treatment, and the scale of the challenge facing those responsible for helping them. “The impact of this on young people and those around them can be devastating, but it’s also a huge issue for society,” Mr Bunt said.
Anxiety is the top concern cited by callers to YoungMinds’ parent helpline, but there’s no single factor that could explain the increase in referrals.
“We know that for many, growing up today is incredibly tough,” Bunt said. “Pressures are piling up from a cost-of-living crisis, a devastating war, the climate emergency and unaffordable housing.”
“Add in intense academic pressures and uncertain futures, and it’s no wonder more young people than ever are struggling with their mental health.”
Children who have experienced a distressing or traumatic experience, such as a car accident or a house fire, may feel anxious afterwards. Arguments or conflicts within the family may also make children feel anxious or worried.
One young person who has struggled with anxiety since the age of 13 said it led to a fear of hurting their family: “I was worried I would spread germs and dirt.
“I dropped food on the floor and panicked because I was worried someone would have an allergic reaction. It kept me up for days.”
A Guardian investigation found that the number of referrals for anxiety disorders has doubled since the year before COVID-19, to 98,953 referrals between 2019 and 2020.
Julia Clements, lead educational psychologist at children’s mental health charity Place2Bee, said the impact of the pandemic – disease and disruption – could not be underestimated.
“The pandemic and subsequent global situation over the past few years have been challenging times for many people, including children and young people, so it is not surprising that we have seen an increase in referrals to mental health services relating to anxiety.”
Many of the doctors, NHS workers and health leaders interviewed expressed concern that while a lot of work is being done to raise awareness of children’s mental health, less attention is being paid to ensuring the health service is able to support those in need.
Dr Elaine Lockhart, director of child and adolescent care at the Royal College of Psychiatrists, said that “mental health services are struggling to cope with rising demand”, with the result that many children referred with anxiety disorders are on unacceptably long waiting lists.
The danger is that this could cause further harm at a critical time in their lives, Lockhart said.
Although the government has made efforts in recent years to expand services for children with anxiety disorders, they remain underserved. It will be vital to open more early help hubs and provide more staff in schools and the NHS so that children can get support in their local community when they need it.
“The urgent need for better mental health supports for young people has never been greater,” Mr Bunt said. “The systems around young people are failing them. Whether it’s schools or mental health services, these systems are overburdened, underfunded and unable to meet the needs of modern life.”
The priority for ministers and the NHS should be to give the health service the tools it needs to cope with growing demand and ensure that every child with anxiety receives prompt, compassionate treatment.
On top of that, a focus on prevention is key, and that means addressing the causes of anxiety in children — but with so many factors at play, that’s easier said than done.
