Children in mental health crisis waiting up to three days in A&E for specialist bed in England | Mental health
In England, children and young people suffering a mental health crisis spend up to three days in an A&E unit before getting a bed in a specialist unit, NHS figures reveal.
A children’s nurse who works in an emergency department said such long waits for under-18s in acute distress were “frankly barbaric” but were “becoming a lot more normal”.
Some of those who find themselves stuck in emergency rooms become so troubled and disruptive that staff increasingly use drugs to sedate them to manage their behavior.
The Royal College of Nursing (RCN) said the delays highlighted a “catastrophic system-wide failure” of NHS mental health services to intervene to prevent school-age children falling into crisis. Seeking help from A&E was often “harmful and potentially traumatic” for them, it says.
Freedom of Information requests made by the RCN to NHS trusts in England also revealed that the number of under-18s in mental health crisis forced to wait at least 12 hours before being admitted to a mental health unit had more than tripled, from 237 in 2019 to 802 in 2025.
Three trusts – Barts Health Trust and Lewisham and Greenwich Trust, both in London, and Morecambe Bay Trust in Cumbria – told the union that children and young people had spent three days or more waiting for a bed in their A&E.
An emergency nurse said such long waits were “extremely distressing” for the patients involved and the staff caring for them. Another said: “A&E is just seen as a big repository for all kids who are dysregulated or in crisis. But A&E is not a respite for kids with mental health issues. It can often exacerbate their trauma.”
Dr Sam Jones, a mental health researcher at the Royal College of Paediatrics and Child Health (RCPCH), said children in mental health crises were now often sicker than in the past.
“Along with rising levels of poor mental health, the nature of needs is changing rapidly. The problems are more complex and serious, more and younger children are being affected and rates of self-harm and eating disorders continue to rise,” Jones said.
The RCN estimates that almost 500,000 under-18s have sought help for mental health problems in A&E units in England since 2019. Two thirds (80) of the trusts it asked for data provided it. Responses showed that hospitals treated a total of 330,367 of these patients between 2019 and 2025.
When she extrapolated this number to include the 45 trusts that did not respond, she estimated that all trusts took in a total of around 492,350 children and young people in severe mental distress.
Professor Nicola Ranger, general secretary and chief executive of the RCN, said: “Half a million children and young people attending emergency departments in mental health crises 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 emergency mental health units so under-18s can seek help away from A&E.
Rebecca Gray, director of the NHS Alliance mental health network, said: “Too often, young people with mental illness end up going to hospital emergency departments and [are] faced with very long waits in an inappropriate, even harmful, environment. This is bad for patients and staff.
An NHS England spokesperson said: “Busy emergency departments are not the right place for anyone in a mental health crisis, which is why children can access 24/7 support through NHS 111, combining crisis assessment, rapid response and treatment at home if necessary.
“The NHS has also expanded mental health services, with 70% more children accessing support than before the pandemic, while mental health support teams are also being deployed to schools to provide earlier help and prevention. »
