Child mental health in focus: key lessons from the RCPCH State of Child Health 2026

Written by Julia Jones, Tyla Glover, and Claire Bentley.

The Royal College of Paediatrics and Child Health's (RCPCH) has published its State of Child Health 2026 which identifies children's mental health as one of the most pressing challenges facing the UK. The report includes a dedicated mental health indicator, underlining the growing importance of children's mental health as a policy and service priority. 

Rising need and worsening outcomes

In the 2020 State of Child Health update, it was reported that the proportion of children and young people with a ‘probable’ mental health disorder had increased 1.5% over the last decade. The most recent report highlights a sustained increase in the number of children and young people experiencing significant mental health difficulties. In England, the proportion of 8 to 16-year-olds assessed as having a probable mental health disorder had increased from 12.5% in 2020 to 20.3% by 2023. 

The impact extends beyond healthcare. Mental health difficulties are associated with increased school absence and poorer educational outcomes, while children report difficulties accessing support in school settings and concerns about whether staff are equipped to help. 

Inequalities remain a major concern

The report finds that mental health problems are not evenly distributed across the population. Children living in poverty, those with disabilities, looked-after children, carers, refugees and asylum seekers, and LGBT+ young people are at greater risk of poor mental health outcomes. Deprivation continues to be a significant driver of need across all areas of child health. 

RCPCH also highlights a range of contributing factors, including childhood adversity, loneliness, bullying, neurodivergence, chronic illness and the lasting effects of the COVID-19 pandemic. 

Services under pressure

The report warns that demand for Child and Adolescent Mental Health Services (CAMHS), neurodevelopmental services and community paediatric services continues to outstrip capacity. Children and young people are increasingly presenting in crisis, including in emergency departments that are often not designed or staffed to meet complex mental health needs. 

A recurring theme throughout the report is the need for earlier intervention. RCPCH argues that many children are unable to access support until their needs have escalated, increasing pressure on specialist and crisis services. 

What does this mean for health and care organisations?

The report's message is clear: improving children's mental health requires investment in prevention, early intervention and community-based support. For NHS trusts, ICBs, mental health providers and local authorities, key priorities include:

• Expanding access to community and school-based mental health support. 
• Reducing waiting times for CAMHS and specialist services. 
• Strengthening partnership working across health, education and the voluntary sector. 
• Targeting support towards children most affected by inequality and deprivation
• Improving data collection and outcome measurement to support service planning

Looking ahead

The wider State of Child Health 2026 report concludes that the UK risks raising one of the unhealthiest generations of children in recent decades unless action is taken to address inequalities, improve services and invest in the child health workforce.

Mental health is one of the clearest examples of this challenge, with rising levels of need, stretched services and significant variation in access to support. 

For health and care organisations, the report reinforces the importance of prevention and early intervention if children and young people are to receive help before reaching crisis point.

The Mental Health Act 2025 reforms will also have an important impact on child and adolescent mental health. Join our Mental Health Act 2025 Community to receive timely updates, practical insights and expert commentary as developments under the Act go live. 

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How we can help

Our specialist Children’s Services and Mental Health teams advise NHS trusts, integrated care boards, local authorities and independent providers on the legal and regulatory issues arising from the delivery of children’s mental health services.

We regularly advise on:

• the application of the Mental Health Act and Mental Capacity Act;
• safeguarding responsibilities and children’s rights;
• consent and treatment decisions involving children and young people;
• governance and service transformation;
• investigations, inquests and complex public law matters.