One in five young people in the UK now access specialist mental health care by age 18 – a four-fold increase in under two decades, new research suggests.
Figures from Wales – which researchers say serve as an accurate indicator for the whole of the UK – indicate a consistent year-on-year rise in service use, with a sharp acceleration after 2010.
Experts warn that existing services may no longer meet the needs of today's young people, with many treatment decisions based on decades-old evidence.
Rates of mental ill health among young people have been rising across the world. Despite this, there has been a lack of evidence on the proportion of young people using specialist NHS child and adolescent mental health services (CAMHS), and how this has changed over time.
Researchers from the University of Edinburgh tracked children born in Wales from 1991 to 2005 to measure how many had accessed specialist care before their 18th birthday.
They found that, of all individuals born in 1991, 5.8 per cent had attended CAMHS before they turned 18 in 2009. In comparison, of all individuals born in 2005, 20.2 per cent had attended CAMHS by the time the turned 18 in 2023 – a rise from one in 17 young people to one in five.
The findings provide the reliable service-use data that is critical for planning, policymaking and evaluating how well systems are responding to rising need, experts say. Given the similar clinical framework for CAMHS and the shared, long-term drivers of demand across the four nations, the researchers say that trends from Wales likely apply to all of the UK.
The study analysed anonymised administrative health records from the Secure Anonymised Information Linkage (SAIL) databank, which covers most of the Welsh population.
Adolescents were far more likely than younger children to be in touch with CAMHS. In the early 2000s there were similar numbers of boys and girls attending services, but by 2022 there were nearly twice as many girls as boys.
The findings highlight the pressing need for more research into the factors driving the rising demand and an assessment of the real-world effectiveness of interventions offered in CAMHS, experts say.
Ian Kelleher, study lead and Professor of Child and Adolescent Psychiatry at the University of Edinburgh, said: "This study provides the clearest picture yet of the soaring demand for CAMHS. There has been a seismic shift in the numbers coming to CAMHS but there has been far too little research to understand why this is the case. Contrary to a lot of public discourse, this is not a post-pandemic issue – this trend has been building consistently for over a decade.
"Unlike oncology or cardiology services, there is far too little research and evaluation taking place in CAMHS. Clinicians want to provide the best possible care but we need stronger modern evidence on which to base our treatment decisions. Robust clinical research programmes are not a luxury, they are the only way to ensure our systems and treatments are effective for today's young people."
The study is published in the journal British Journal of Psychiatry: https://DOI.org/10.1192/bjp.2025.10480 [URL will become active after embargo lifts]. It was funded by the Academy of Medical Sciences.
