Annual referrals for autism have risen by almost 50%, according to Children’s Commissioner report

A new report from the Children’s Commissioner has found that referrals for autism and neurodevelopmental conditions are driving increased demand for children’s mental health services.

New data for 2024-25 show that more than one million children had an active referral to Children and Young People’s Mental Health Services (CYPMHS), exceeding the system’s capacity. This is almost double the number recorded in 2018-19 and a 10% increase on the previous year.

Referrals for suspected autism rose by almost 50% in a single year, from 65,530 to 96,393. Referrals for other neurodevelopmental conditions increased by 24%, making them among the fastest-growing reasons children seek support. However, these children were most likely to face some of the longest waits for help.

Mental Health Strategy and reforms to the SEND system

Dame Rachel de Souza is now calling on the Government to place a specific focus on children in the recently announced national Mental Health Strategy to ensure that children with additional needs, neurodevelopmental and mental health conditions receive help at the earliest possible point.

She said:  There is no disguising the fact the figures in this report are stark. Roughly one in 10 children have an active referral to mental health services in England which clearly demonstrates the sheer scale of distress young people are facing today. These are not just numbers, but children whose lives have been put on hold for months and, in some cases, years waiting for support they urgently need.

“With the upcoming 10 Year Mental Health Strategy and reforms to the SEND system, we have a once in a generation opportunity to transform children’s mental health and improve outcomes for children. In order for these to have the most impact they must be shaped and informed by children’s own experiences and must be done collaboratively – not working in isolation – so that services offer earlier support, shorter waits and reflect what young people say they need to thrive.”

Waiting times for autism and neurodevelopmental conditions

The report also found that slightly more children are receiving treatment than in the previous year, but more children are also waiting for support. Over a third of children (35%) referred to CYPMHS were still waiting for treatment at the end of the year, up from 29% two years earlier.

More than 60,000 children had been waiting over two years for treatment by the end of March 2025 – an increase of more than 15,000 compared to the previous year. Children waiting for support waited an average of 224 days. Those referred with suspected autism faced some of the worst outcomes – with just 13 per cent going on to receive treatment by March 2025, and those who did receive treatment waited a year on average for support.

The Commissioner’s analysis also looked at how the level of deprivation of where children live impacted their mental healthcare use. Children in both rich and poor areas were being referred in large numbers; however, children from more deprived areas were most likely to be referred and go on to be treated by CYPMHS than children from less deprived areas.

Children from the poorest 10% of areas made up 15% of those referred, compared with 7.6% from the least deprived areas. Children from poorer areas were more likely than children from richer areas to receive treatment, and to have shorter waits before receiving treatment.

Black and Asian children are also underrepresented in referrals to CYPMHS and when they are referred, they are much more likely to be referred for being ‘in crisis’. One in four Black children referred to CYPMHS were referred for being in crisis, compared with 16 % of Asian children and 7.4% of white children – raising questions about why some children from ethnic minority backgrounds are not receiving help earlier.

Recommendations from the mental health report

Recommendations in the report include:

• Addressing the drivers of poor mental health and wellbeing.
• Ensuring a robust evidence base for treatments and interventions is provided in schools, the community and inpatient settings.
• Creating a shared and agreed assessment framework between health and education for children presenting with neurodevelopmental needs and developing a consistent, shared pathway between community paediatrics and CYMPHS for these children.
• Developing alternative pathways which ensure suitable provision for children with complex social, emotional and mental health needs resulting from trauma, and children with learning disabilities and/or autism with escalating needs.​
• Introducing better data and accountability for children’s experience of mental health services. The strategy must include an outcomes framework that assesses children’s journeys through the system and the effectiveness of treatment and interventions.​

Mel Merritt, Head of Policy and Campaigns at the National Autistic Society, said: “The Children’s Commissioner’s report clearly shows autistic children and young people are being failed. They face unacceptable average waits of a year for a diagnosis and, even after a diagnosis, autistic children wait twice as long as their peers for any support. Only 13% of children waiting for an autism assessment went on to receive support, the rest remain lost in a system that simply isn’t working. Without support they can face escalating mental health issues, crisis, detention in a mental health hospital and even in some cases loss of life.

“Urgent action is needed. The Government needs to stop ignoring this problem. We support the Children’s Commissioner’s calls for improved joint working between services. The Government’s new Mental Health Strategy and the next autism strategy must have funded plans for improving access to support for autistic children and young people.”

Alison Bloomer

Alison Bloomer is Editor of Learning Disability Today.

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