Children in England wait up to three days in A&E for mental health beds

Children and young people in England experiencing a mental health crisis are waiting up to three days in an emergency department before receiving a bed in a specialist unit, according to NHS figures.

One children’s nurse who works in an emergency department described such long waits for under-18s in acute distress as “frankly barbaric” but said they were “becoming far more normal”.

Some young people who end up stranded in A&E become so troubled and disruptive that staff are increasingly using medication to sedate them in order to manage their behaviour.

The Royal College of Nursing (RCN) said the delays underscore a “catastrophic system-wide failure” by NHS mental health services to intervene before school-age children reach crisis point. Seeking help in A&E, the RCN added, is often “damaging and potentially traumatising” for them.

Freedom of information requests submitted by the RCN to NHS trusts in England revealed that the number of under-18s in mental health crisis forced to wait at least 12 hours before admission to a mental health unit 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 the Morecambe Bay trust in Cumbria – told the union that children and young people had spent three days or more waiting in their A&E departments for a bed.

One A&E nurse said such prolonged waits were “extremely distressing” for the patients involved and for the staff caring for them.

Another nurse said: “A&E is just seen as this big receptacle for all children who are dysregulated or in crisis. But A&E is not respite for children with mental health concerns. It can often exacerbate their trauma.”

Dr Sam Jones, the research officer for mental health at the Royal College of Paediatrics and Child Health (RCPCH), said children in mental health crisis are now often more unwell than in the past.

“Alongside rising levels of poor mental health, the nature of need is changing fast. Problems are more complex and severe, more younger children are affected and rates of self-harm and eating disorders continue to rise,” Jones said.

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 requested data from provided information.

The responses showed that hospitals treated a total of 330,367 such patients between 2019 and 2025. When the RCN extrapolated that number to include the 45 trusts that did not reply, it estimated that all trusts saw approximately 492,350 children and young people in severe mental health distress.

Prof Nicola Ranger, the RCN’s general secretary and chief executive, 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 accelerate the rollout of a planned network of mental health emergency units so that under-18s can access help away from A&E.

Rebecca Gray, director of the NHS Alliance’s mental health network, said: “Too often young people with mental illness end up going to hospital emergency departments and [are] facing very long waits in an inappropriate or even harmful setting. This is bad for patients and staff.”

An NHS England spokesperson said: “Busy A&Es 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 home treatment where needed. 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 rolled out in schools to provide earlier help and prevention.”