The Rising Tide of Youth Mental Health Services

Credit: Adobe Stock/LIGHTFIELD STUDIOS

A new study published in The British Journal of Psychiatry shows a dramatic rise in the number of young people accessing mental health services in Wales over the past two decades.

Mental health concerns among children and teenagers have been rising around the world, and more young people are being referred to child and adolescent mental health services (CAMHS). But we haven’t had a clear picture of how many young people are actually using these services — or how those numbers have changed over time. This study looked at long-term health data from Wales to understand these trends.

Investigators examined almost 20 years of Welsh administrative health care records to see how many children and adolescents had contact with CAMHS between 2004 and 2023. They also looked at “lifetime prevalence,” meaning how many young people born in a specific year had ever accessed CAMHS by the time they turned 18.

The findings show a dramatic increase in the number of young people seeking mental health support.

• In 2004, fewer than 1% of children and teens (0.8%) had contact with CAMHS.
• By 2022, that number had jumped to nearly 4% (3.9%) — almost five times higher.

The lifetime numbers tell an even clearer story. Among young people born in 1991 (who turned 18 in 2009), only 5.8% ever used CAMHS before adulthood — that’s about one in 17 teenagers. But for those born in 2005 (who turned 18 in 2023), the percentage skyrocketed to 20.2%, or one in five young people.

“The rapid change in numbers in contact with CAMHS raises serious concerns for the state of child mental health in the U.K.,” wrote investigators. “Failure to treat mental health conditions can lead to poor long-term health, education and social outcomes, highlighting the urgent need to scale-up evidence-based mental health support for young people.”

In short, investigators say today’s children and teens are far more likely to come into contact with mental health services than those from past generations. This could reflect rising mental health needs, increased awareness of mental health issues, reduced stigma, better access to services or all of the above.

The team pointed to the use of comprehensive health records from across Wales as a strength of the study, which helped avoid common research biases. However, it only included young people continuously registered with a general practitioner, which may leave out groups like refugees or families who move frequently — groups that often face higher mental health risks. Some older data were incomplete, and private mental health care wasn’t captured, meaning the true number of young people contacting CAMHS is likely higher than reported. Finally, the study could not assess how often young people used services or what treatments they received, but the overall accuracy of CAMHS contact data appears strong based on comparisons with previous surveys.

Overall, the study highlights just how rapidly and significantly youth mental health service use has grown. Understanding these trends is crucial for planning resources, supporting families and ensuring that mental health services can keep up with rising demand.

“There is a need to prioritize more intensive research activity within CAMHS to improve our understanding of the factors driving these increases in presentations but also, in the context of a rapidly changing target population, to evaluate the effectiveness of existing CAMHS interventions and to develop new, evidence-based interventions that are fit for purpose,” investigators concluded.