Variable waiting times in England’s publicly funded Child and Adolescent Mental Health Services: implications for equity and outcomes
1
Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Over the past decade, rates of mental health difficulties among children and young people (CYP) have risen each year, identified by the World Health Organization as an urgent public health crisis. This has placed sustained strain on many public mental health care systems, contributing to prolonged waiting times. Despite this, there is limited evidence on who waits, for how long, and whether prolonged waiting is associated with poorer mental health outcomes.
METHODS:
To assess waiting times and how they relate to mental health outcomes across sociodemographic groups, we used administrative and clinical data from over 71,000 CYP who accessed a publicly funded mental health care system in south London, England from 2007-present. Waiting times were measured from date of referral to date of treatment initiation. Mental health outcomes were measured as changes in parent-reported symptom level from the beginning to end of treatment. We used regression models to measure associations between waiting time, symptom change, and key sociodemographic covariates including ethnicity and area deprivation.
RESULTS:
Waiting times for CYP varied substantially (mean = 160 days ± 343, median = 59), with sociodemographic factors explaining approximately a quarter of variance. Longer waiting times significantly but minimally predicted less improvement in symptoms over the course of treatment, accounting for less than 1% of model deviance.
CONCLUSIONS:
Our findings show substantial but highly variable waiting times in the Child and Adolescent Mental Health Services of a trust in London, England, with marked sociodemographic disparities indicating potential inequity in access to care. While longer waits are associated with only modestly worse treatment outcomes, they also prolong periods of mental distress for vulnerable CYP pre-treatment. As many countries face similar pressures on publicly funded mental health services for CYP, monitoring and addressing waiting times is critical for ensuring equitable access and improving CYP’s wellbeing.
Over the past decade, rates of mental health difficulties among children and young people (CYP) have risen each year, identified by the World Health Organization as an urgent public health crisis. This has placed sustained strain on many public mental health care systems, contributing to prolonged waiting times. Despite this, there is limited evidence on who waits, for how long, and whether prolonged waiting is associated with poorer mental health outcomes.
METHODS:
To assess waiting times and how they relate to mental health outcomes across sociodemographic groups, we used administrative and clinical data from over 71,000 CYP who accessed a publicly funded mental health care system in south London, England from 2007-present. Waiting times were measured from date of referral to date of treatment initiation. Mental health outcomes were measured as changes in parent-reported symptom level from the beginning to end of treatment. We used regression models to measure associations between waiting time, symptom change, and key sociodemographic covariates including ethnicity and area deprivation.
RESULTS:
Waiting times for CYP varied substantially (mean = 160 days ± 343, median = 59), with sociodemographic factors explaining approximately a quarter of variance. Longer waiting times significantly but minimally predicted less improvement in symptoms over the course of treatment, accounting for less than 1% of model deviance.
CONCLUSIONS:
Our findings show substantial but highly variable waiting times in the Child and Adolescent Mental Health Services of a trust in London, England, with marked sociodemographic disparities indicating potential inequity in access to care. While longer waits are associated with only modestly worse treatment outcomes, they also prolong periods of mental distress for vulnerable CYP pre-treatment. As many countries face similar pressures on publicly funded mental health services for CYP, monitoring and addressing waiting times is critical for ensuring equitable access and improving CYP’s wellbeing.
| eISSN: | 2654-1459 |
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