Cambridge researchers say children in care or subject to protection plans are two to three times more likely to be referred for mental health support, yet only a minority receive help each year.
Researchers at the University of Cambridge say thousands of England’s most vulnerable children and young people are still missing out on mental health support, even though their need is often greater than that of their peers. The study, published in Child and Adolescent Mental Health, examined NHS Digital records covering referrals and contact with services from 2016 to 2021 and found that children on child protection plans or in care were far more likely to need help, yet only a minority were seen by mental health services in any given year.
The findings suggest a gap between demand and treatment that has become more visible as pressure on services has increased. Almost 2 million children and young people were in contact with mental health services over the five-year period, with figures rising each year. Anxiety was the most common reason for referral, followed by crisis presentations, depression, neurodevelopmental conditions and self-harm, although the main reason for referral was not recorded in most cases, according to the Cambridge report.
The researchers said children who are subject to child protection plans or living in care were roughly two to three times more likely than other children to be referred, but still only about 9% to 18% had contact with services in a given year. Robbie Duschinsky, who leads the Child Health and Development Research Group at Cambridge, said his team had seen repeated examples of young people being turned away because their situations were judged too complex or better handled by social services. In one case described by the researchers, a 12-year-old girl in residential care was considered too complex for intensive specialist help after a suicide attempt; in another, a 12-year-old boy was refused CAMHS support after an overdose scare and running away from foster care because his difficulties were seen as rooted in his social circumstances.
The study also found that contact with services tended to level off, or even fall, at ages 17 and 18, despite late adolescence being a period of heightened risk for mental illness. The authors suggested this may reflect weaker advocacy for older teenagers, alongside the fact that some young people do not want treatment and their wishes are respected. They also said children and young people who identified as Asian or Black appeared less likely to be in contact with mental health services than population estimates would suggest, pointing to continuing inequalities in access.
Barry Coughlan, the study’s first author, said the data showed a steady rise in demand but a system that is failing to reach some of the children who need it most. Earlier research cited alongside the Cambridge work has also found that access to child and adolescent mental health services has been under strain, particularly since the pandemic, while other studies have explored whether digital referral systems and mobile apps could help remove some of the barriers that keep young people from seeking help. The Cambridge team said their analysis is the first to use NHS Digital child mental health data in this way, underlining the value of routine records in exposing health inequalities.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
