More than twice as many children and adolescents were referred to mental health services year on year in England as cases hit a record high. The findings have been called “heartbreaking” and “awful” by the new chair of the Royal College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry. Dr Elaine Lockhart also warned that waiting lists were so long that significant numbers of young people would not get treatment in time to prevent them growing into adults with “entrenched mental health issues that could have been avoided had we been able to intervene earlier”. She added: “It is difficult to consider these numbers and know that behind each one is a child or young person, and a family, who are in distress. “Children and young people’s mental health has been neglected for years and in the meantime, we know that the need is increasing. We were already struggling to meet demand before the pandemic,” she said. “But the pandemic has absolutely resulted in increase in mental health disorders in children and young people.” The new data revealed a record high for referrals to child and adolescent mental health services in March 2021. At 65,533, it is more than double the number in March 2020 and 68% higher than March 2019. Between 2020 and 2021, the data reveals there were 527,339 referrals in total, compared with 397,822 between 2019 and 2020, which shows a 33% year-on-year increase. Emergency referrals to crisis-care teams for under-18s were 62% higher in March 2021 than the previous year. There was also a record high number of urgent referrals for under-18s in March 2021, up 58% compared with March 2020. Lockhart said the pressure on services was so extreme that a child with an anxiety disorder significant enough to stop them from leaving the house could not rely on being seen urgently. “There’s only so much capacity in the system: that child would keep getting pushed aside because even more acutely unwell children are coming up behind them,” she added. Lockhart said the situation had not improved since a 2017 landmark national study found that one in five children with a mental health disorder had waited more than six months for contact with a mental health specialist. That same year, the NHS admitted that less than one-third of children and young people estimated to have a mental health condition were able to benefit from treatment and support. Waiting lists are now so long that private child psychiatrists say they have seen the number of self-funding patients triple during the pandemic. Dr Hayley van Zwanenberg, a consultant child and adolescent psychiatrist at the Priory Group, said three-quarters of her new clients were self-funded while only 25% have insurance. Before the pandemic, she said, the numbers were reversed. “My waiting list used to be between two and six weeks,” she added. “But the numbers have increased exponentially and my waiting list is now three to four months. It’s never been so long.” She also said that the severity and complexity of the mental health issues experienced by children who come to her were significantly worse than prior to the pandemic for reasons directly related to lockdown.