Children and young people in England experiencing a mental health crisis are now spending up to three days in an A&E unit before securing a bed in a specialist facility, according to NHS figures that suggest the system is less a safety net and more a particularly grim waiting room.
One children’s nurse working in an emergency department described these long waits for acutely distressed under-18s as “frankly barbaric” but noted they are “becoming far more normal.” Some stuck in A&E become so troubled and disruptive that staff are increasingly using medication to sedate them - turning emergency care into an impromptu chemical management system.
The Royal College of Nursing (RCN) called this a “catastrophic system-wide failure” by NHS mental health services, noting that seeking help at A&E is often “damaging and potentially traumatising” for young people. Freedom of information requests by the RCN to NHS trusts found that the number of under-18s forced to wait at least 12 hours before admission to a mental health unit more than trebled, from 237 in 2019 to 802 in 2025.
Three trusts - Barts Health trust and Lewisham and Greenwich trust in London, and Morecambe Bay trust in Cumbria - reported children waiting three days or more in A&E. One nurse described these waits as “extremely distressing” for patients and staff, while another lamented that “A&E is just seen as this big receptacle for all children who are dysregulated or in crisis. It can often exacerbate their trauma.”
Dr Sam Jones, research officer for mental health at the Royal College of Paediatrics and Child Health (RCPCH), said children in crisis are now often more unwell than in the past, with problems becoming more complex and severe, affecting younger children, and driving rising rates of self-harm and eating disorders.
The RCN estimates that nearly 500,000 under-18s have sought help for mental health problems at A&E units in England since 2019. Two-thirds (80) of the trusts it surveyed provided data, showing 330,367 such patients between 2019 and 2025. Extrapolating to include the 45 trusts that didn’t respond, the RCN estimates around 492,350 children and young people have been in severe mental health distress.
Prof Nicola Ranger, the RCN’s general secretary, said: “Half a million children and young people attending A&E in a mental health crisis is evidence of a catastrophic system-wide failure.” The RCN and RCPCH are urging ministers and NHS bosses to speed up the rollout of a planned network of mental health emergency units so under-18s can seek help away from A&E.
Rebecca Gray, director of the NHS Alliance’s mental health network, noted that “too often young people with mental illness end up going to hospital emergency departments and facing very long waits in an inappropriate or even harmful setting.” An NHS England spokesperson countered that “busy A&Es are not the right place for anyone in a mental health crisis,” pointing to 24/7 support via NHS 111 and expanded mental health services serving 70% more children than before the pandemic, with mental health support teams rolling out in schools to provide earlier help and prevention.