Three groups of young people who are missing out on mental health support

We are witnessing a mental health crisis among children and young people in England.

Over the past decade, the number of young people struggling with their mental health has climbed, and many of them are not receiving the support they need.  

Here are three groups of young people who are falling through the gaps in our mental health system.  

1. Children and young people waiting for long periods on Child and Adolescent Mental Health Services (CAMHS) waiting lists

Many children and young people face long wait times to receive support from CAMHS, leaving them without help when they need it most.  

Of the 949,200 children and young people referred to Children and Young People’s Mental Health Services (CYPMHS) during the 2022-23 financial year, 270,300 (28%) were still waiting for care at the end of the year, with an average wait time of 108 days.

Some have been waiting up to three years for their first appointment. However, not all areas experience such long delays—some report average wait times as short as 4 days—revealing the postcode lottery in access to timely mental health support. 

Prolonged waiting isn’t just frustrating, it can cause a young person’s mental health to deteriorate, leading to crisis situations. Going without proper treatment can also impact a young people’s school attendance and personal relationships, and erode trust in mental health services. 

2. Children and young people who need more support than can be offered in schools but who are not eligible for CAMHS 

Some young people fall into a “grey zone” where their needs are considered too complex for school-based support, but they do not meet the threshold for CAMHS. This leaves them without adequate support and can also lead to a deterioration of their mental health.  

The ‘missing middle’ is a term used to describe these young people who fall through the gaps between different levels of mental health support. While it is hard to determine the actual size of the missing middle, it is possible that quite a few of the 372,800 young people whose referrals were closed before accessing CAMHS in 2022-23 would be considered in this group.

We need more research into the experiences and needs of the missing middle, and we need services that are equipped to support those needs. 

3. Children and young people who disengage during a transition from CAMHS to Adult Mental Health Services 

Young people often struggle with the transition from CAMHS to adult services, with many falling through the cracks. This transition often coincides with other major life changes, like finishing school and going to university or joining the workforce, making it even more challenging.  

Several other factors make it even harder to transition smoothly, including long wait times between the end of CAMHS support and the start of adult mental health services, as well as big differences in how these services are delivered.  

Unfortunately, during or just after this transition, some young people disengage from services entirely, only to re-engage later in a crisis. 

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All young people struggling with their mental health deserve support, but unfortunately right now many are missing out. 

We will be taking a closer look at what is happening for each of these groups of young people and exploring how we can build a mental health system that leaves no young person behind.