Why the Children’s Commissioner’s Mental Health Report Should Prompt Urgent Change
“I have been waiting for months and months to have someone to talk to about my mental health […] I am not surprised how high the suicide rate is of young people around my age, when you are waiting months - years for any kind of intervention or help.”
Girl, 17, The Big Ambition
Each year, the Children’s Commissioner for England publishes a report on children and young people’s access to mental health services. And each year, we hear the same story.
Too many children are waiting too long.
Too many children are told they’re not ‘ill enough’ to get help.
And too many children are reaching a crisis point, or worse, before any support is put in place.
This year’s report, covering 2023-24, brings those stories into sharper focus than ever. As well as compelling and uncomfortable statistics, this year we have the voices of children themselves, speaking with painful clarity about what it’s like to grow up in a system that only catches you when you fall. And sometimes not even then.
- 31% of children referred to NHS mental health services had their referrals closed before accessing CYPMHS
- Some children in crisis are waiting a median of 60 days for support
- Only 44% of pupils in Englandhave access to a Mental Health Support Team (MHST) in their school.
- There were 59,732 crisis referrals in the last year, up 7.7% from the year before.
Yes, these figures are compelling enough on their own, but behind every one of those numbers is a child. A family. A teacher or school counsellor trying to hold the situation together while they wait.
As the Commissioner puts it, “Children are crying out for our help so they can get on with their lives, and we must listen.”
Perhaps the most powerful aspect of this year’s report is the inclusion of children and young people’s voices, gathered through The Big Ambition - the largest survey of its kind in recent years.
Children spoke openly about being turned away from services:
“Mental health support is totally limited. You have to be "in" crisis before CAMHS can see you. Why is there not more?”
Adult on behalf of girl, 18, The Big Ambition
They talked about struggling alone, about being misunderstood, and needing more support:
“Teachers are unequipped to deal with conditions such as social anxiety, generalised anxiety and panic disorders [...] not all students express their feelings on their faces, or in their attitudes, some bottle them up and are unable to help due to feeling scared of them or are intimidated by a lot of teacher's attitudes”
Child, 16, The Big Ambition
“Body image and eating disorders is a huge problem at school and with kids my age. I don’t think anyone of my friends hasn’t struggled with eating”
Girl, 15, The Big Ambition
Or the impact of long waiting lists on real people:
“Actually help kids with mental health problems instead of leaving them on a waiting list most of their teenage years”
Girl, 13, The Big Ambition
“The waiting lists are currently far too long leaving struggling children and teens unsupported for long periods of time. This only worsens the difficulties they are facing, and early support is key when needing help with mental health”
Girl, 16, The Big Ambition
“More support for children whether it be mental health, abuse, sexual abuse etc, there’s always a huge waiting list for them to be seen which is unfair, get them the help they need”
Girl, 13, The Big Ambition
“[We need] better mental health services for children, faster access, waiting times are too high. My brother has an 18 week wait to get help for his mental health problems in the meantime mum is trying to keep him safe with no support or guidance, even though he threatens to end his life. 18 weeks is a very long time when you are in a really bad place mentally”
Boy, 18, The Big Ambition
One of the most damaging features of the current system is how often children are told they’re not ‘unwell enough’ to qualify for support. As the report makes clear, thresholds are too high, and the system too reactive. And when children are finally accepted for help, they often wait months between their first contact and meaningful, ongoing therapeutic support. In fact, the Children’s Commissioner clearly measures waiting times not to the first contact (which will be triage or assessment), but to the second direct contact: the point at which actual help is likely to begin.
What’s missing: counselling & the human connection
While the report calls for many things the Society has long supported (earlier access, community-based models, support that doesn’t require a diagnosis) there are some glaring omissions.
First, the absence of any mention of counselling in schools. Despite its widespread presence, its strong evidence base, and the fact that many children are already engaging with counsellors on a regular basis, school-based counselling is not referenced. Meanwhile, the role of school nurses is rightly highlighted, but counsellors are once again invisible in policy conversations.
Second, the report talks about moving away from a medicalised model of care, but it doesn’t name what should replace it. There's no mention of relational working, of therapeutic relationships, or of the importance of a consistent, trusted adult who can walk alongside a child as they navigate their experiences.
The report notes that children and young people describe feeling “unseen, disconnected, alone”, yet doesn't raise any concerns around the move from analogue to digital in the NHS 10 Year Plan, which is something that I hope the Children's Commissioner will pick up on for the 2026 report.
Children have told us they’re already feeling unseen and unheard. We must be careful not to design systems that mirror that back to them.
The NCPS has long campaigned for Access to Counselling for Every Child. We’ve called for every school to have a dedicated counsellor, embedded in the school community, available to children without the need for a diagnosis or referral. We've also actively supported Barnardo's MHST+ model, which calls for a counsellor to be included within every MHST to ensure that the 'missing middle' are able to get the support they need.
Given the significant workforce of counsellors who are trained to work with young people, that are often doing so in privately funded spaces, why are we not drawing on this workforce to bring down waiting lists? Why are we determined to send every child to CYPMHS (CAMHS), only for them to be turned away? Why aren't we reaching them with appropriate services (counselling) before they get to crisis point?
This report echoes so much of what we’ve been saying for years. But it also highlights how far we still have to go.
“This report makes clear that children are being let down by a fragmented system: one that's reactive, diagnostic, and often out of reach. What’s needed now is a clear commitment to early, relational, face-to-face support. That includes counselling, and it must be named as such. This is what children are asking for, and it’s what they deserve”
— Meg Moss, Head of Public Affairs & Advocacy, NCPS
