Even for those who see children with anxiety in the NHS every day, the figures are staggering.
“They really make your jaw drop,” said a doctor who works in children’s mental health services in the north of England. “Obviously we’ve seen an increase in demand, but to see these numbers in black and white … it’s extremely shocking.”
A Guardian investigation published on Tuesday reveals that the number of children being referred to NHS mental health services in England for anxiety has hit the highest level ever recorded.
In 2023-24, there were 204,526 referrals of children to psychiatric services with a primary cause of anxiety.
Although more than twice as many organizations submitted data last year (171) compared to seven years ago (62), the increase in referrals is still extraordinary. In 2016-17, there were just 3,879 referrals, according to a Guardian analysis of NHS data.
“The huge increase in the number of young people struggling with their mental health is one of the biggest social issues of our time,” said Laura Bunt, chief executive of YoungMinds, a children’s mental health charity.
The figures reveal the sheer number of children experiencing anxiety, often without support or treatment, and the size of the task facing those tasked with helping them. “The impact of this on the young person and those around them can be devastating, but this is also a huge problem for society,” Bunt said.
Anxiety is the number one concern raised by calls to YoungMind’s parent helpline. But there is no single factor that explains the increase in referrals.
“We know for many, growing up today is incredibly hard,” Bunt said. “The pressures are piling up from the cost of living crisis, devastating wars, the climate emergency and unaffordable housing.
“Add intense academic pressure and an uncertain future, it’s no wonder more young people than ever are struggling with their mental health.”
Children who have had an upsetting or traumatic experience, such as a car accident or house fire, may experience anxiety afterwards. Family arguments and conflicts can also make children feel insecure and anxious.
One young person who suffered from anxiety from the age of 13 said they developed a fear of harming their family: “I was worried about spreading germs and dirt.
“I had a panic attack when I dropped some food on the floor and was afraid someone would have an allergic reaction. It kept me awake for days.”
The number of referrals for anxiety has doubled since the year before the Covid-19 pandemic, the Guardian found, with 98,953 referrals made in 2019-20.
Julia Clements, a lead educational psychologist at Place2Be, a children’s mental health charity, said the impact of the pandemic – the disease and the disruption – should not be underestimated.
“The pandemic and subsequent world events over the last few years have been a trying time for many – including children and young people – so the increase in referrals for anxiety to mental health services is not surprising.”
Many of the doctors, NHS officials and health leaders interviewed expressed concern that while much work had gone into raising awareness of mental health among children, less attention had been paid to ensuring that the health service was able to help them, who had needs.
Dr. Elaine Lockhart, Chair of the Royal College of Psychiatrists’ Child and Adolescent Faculty, said: “Mental health services are struggling to cope with increasing demand.” The result is that many of the children who are referred for anxiety are on unacceptably long waiting lists.
The danger is that this could cause further damage at a crucial time in their lives, Lockhart said.
In recent years, the government has sought to expand services for children with anxiety, but there is still insufficient support available. Opening more early support centers and recruiting more staff in schools and the NHS so children can access support in their communities when they need it will be critical.
“The urgent need for better mental health support for young people has never been more critical,” Bunt said. “The systems around young people fail 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 rising demand – and ensure every child with anxiety is treated quickly and compassionately.
Beyond that, a focus on prevention is key, which means addressing the causes of anxiety among children. With so many factors involved, however, that will be easier said than done.