• One in five students (4.62) in a virtual class of 22 are now experiencing mental health difficulties, an increase of 20% in just 10 months.
  • One in five teachers say they have witnessed at least one of their students showing suicidal (16%) and self-harm (21%) behaviours.
  • Untreated mental health conditions of children stuck on NHS mental health waiting lists cost schools and specialist education services £69 million a year.

Teachers say that five students in a virtual class of 22 (1 in 5) are now experiencing mental health difficulties as a consequence of the pandemic, an increase of 20% in just ten months. Meanwhile, half of all teachers (56%), including 46% of teachers in primary school, have feared that at least one of their students will come to harm while waiting for mental health treatment over the last year, compared to one third (32%) in 2018, new figures show.

The survey of 500 teachers by youth mental health charity stem4 reveals the true extent of the children’s and young people’s mental health crisis in Britain.

Over the past five months, one in five teachers say they have witnessed at least one of their students showing suicidal (16%) and self-harm (21%) behaviours. Nearly nine in ten (88%) teachers say they have seen pupils suffer with anxiety, and almost half (46%) have witnessed a student with depression. Other common problems include emotional and behaviour disorders (ADHD), aggression and concentration issues (41%), eating disorders (22%), addiction (12%), obsessive compulsive disorders (OCD) (11%), and post-traumatic stress disorder (PTSD) (8%).   

Teachers now refer one in three (29%) students with mental health difficulties to NHS mental health services [Children and Adolescent Mental Health Services (CAMHS)]:

  • 34% say referrals are routinely rejected because they do not meet the threshold of severity.
  • 31% say waiting lists are closed in their area;
  • 29% say referrals are refused because local NHS mental health services have not resumed at full capacity as a result of the pandemic.

When it comes to students who are accepted for treatment, teachers warn that three in ten (30%) of their pupil referrals are stuck on waiting lists for 9 weeks or more. This leads half (48%) of teachers to describe existing health and social care services for students with mental health problems as very or extremely inadequate.

Teachers told the stem4 survey that every child and young person with an untreated mental health condition requires extra help from teachers, while their parents require support. Teachers say they now spend 3.6 hours (average) per week dealing with the mental health difficulties of their students and monitoring children currently on waiting lists, or who have been rejected by CAMHS after referral, to make sure their conditions do not worsen. 

According to a new report published today by charity Pro Bono Economics for stem4, the untreated mental health conditions of children stuck on waiting lists for NHS mental health treatment (CAMHS), are costing public services £75 million each year. £48 million of that cost is borne directly by schools and colleges and £21 million by specialist education services. The remaining £6 million falls to social care and other health services. 

380,000 children waited an average of 7 weeks for NHS mental health treatment in 2018/19, costing public services the equivalent of £200 per child receiving treatment. 23% (87,000) of these children waited more than 12 weeks for treatment, costing public services an average of nearly £500 per child. 


Jon Franklin, Chief Economist at Pro Bono Economics, says:

“Our work highlights that funding decisions for NHS children’s mental health services cannot be made in isolation. Where children are waiting for weeks and months for NHS services, of course there are consequences for the individuals and their families. But schools and teachers are also picking up the tab. The hidden consequences for school costs of lengthy mental health waiting lists for children and young people could be significant.

“Meaningful public debate on this issue is currently hampered by a lack of clear data and information on what different parts of government are spending and how effective that expenditure is. If, as a society, we want to tackle the serious and growing problems with the mental health of the UK’s children then we need more transparency from NHS, schools and other children’s services so that we can see the full picture and deliver coordinated action in an effective way.”

Dr Nihara Krause, Consultant Clinical Psychologist, founder of stem 4, and creator of apps Calm Harm, Clear Fear, says:

“In July 2020 NHS Digital found that 1 in 6 5-16-year-olds had a probable mental disorder, an increase by a third in three years – from 1 in 9 in 2017. This survey suggests that this official figure underrepresents the reality of what is happening nationally.

“Since the start of the pandemic stem4 has recorded over 540,000 downloads of our free NHS-approved mental health apps: Calm Harm, which helps manage the urge to self-harm, and Clear Fear, which helps manage the symptoms of anxiety. Just 17% of stem4’s app users are receiving treatment. During the summer A-level exam results fiasco daily downloads rose from on average 2,000 a day to 12,000 a day.  When we emerge from this third lockdown, we will see mental health distress on an unprecedented scale

“Teachers witness first-hand the devastating impact that isolation, loneliness, family difficulties, education stresses and poverty is having on our children’s and young people’s wellbeing and mental health. The consequences of this can often be serious and life-threatening. Teachers are desperate to help, yet the necessary early interventions and specialist services are not in place to minimise their negative effect.

“If this government is serious about turning the tide of mental ill health in this young generation, it needs to take urgent action now. What children and young people need is access to evidence-based services at all levels, from early prevention through to expert NHS help.”

Dr Nihara Krause and stem4 say more needs to be done on a number of different levels to support children and young people with mental ill health issues. The charity is recommending that:

  • As a consequence of long delays in access to specialist resources, children’s and young people’s conditions worsen and they are presenting with complex mental health needs. More specialist CAMHS services with high-intensity specialists are urgently needed;
  • Children and young people who have been on a waiting list for help will benefit from some sort of intermediate support. Taking the burden off teachers, this support can help monitor and motivate change before young people access treatment. Evidence-based digital support in preparation for face-to-face services may prove useful in this;
  • Children and young people who are experiencing mild-to-moderate mental health difficulties require increased access to specialist early-intervention services. Teachers are at the forefront of addressing this crisis and they need much more support;
  • More than half of children and young people with mild-to-moderate mental health problems do not meet CAMHS thresholds, or wait months to be seen. Waiting times need to be brought down to four weeks.

Download the report