Young people today are facing unprecedented pressure, challenges and worries, leading to an increased demand for children's mental health services, which are struggling to keep up with the demand (Sacco et al, 2022; NHS England, 2023a). In addition to socioeconomic disadvantage, bullying and worries about climate change (NHS England, 2023b), the autumn and start of the school year have been shown to coincide with an increased demand for mental health services for young people that is not seen in other age groups, or at other times of the year (Jack et al, 2023).
While most mental health disorders appear by age 14, the majority remain undiagnosed and untreated well into adulthood (Sacco et al, 2022). Some of the reasons for this include stigma around mental health that persists despite progress, difficulties among parents and teachers identifying signs of mental health issues, limited screening programmes and service availability, lengthy wait lists and a lack of access to services (Sacco et al, 2022).
‘Thousands of children and teenagers in the UK are currently taking antidepressants … without first having seen a specialist, and this number continues to rise’
Causes and effects
Left undiagnosed and untreated, mental health disorders lead to difficulties in all areas of a young person's life, which persist into adulthood (Sacco et al, 2022). Examples include an impaired ability to attain one's educational and career goals and maintain friendships, which progress into more serious issues in adulthood such as restricted occupational opportunities, a greater need for social benefits, involvement in criminality and even higher levels of morbidity and mortality (Sacco et al, 2022).
Mental health disorders that commonly present in young people include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression and anxiety, as well as eating and substance use disorders (Sacco et al, 2022).
Currently, one in five children and young people in England aged 8–25 years had a probable mental disorder in 2023 (NHS England, 2023a). This is up from one in nine in 2017 and, in 2019, suicide was concerningly the leading cause of death for both males and females aged 5–34 years (YoungMinds, 2025). An older study showed that about 60% of young people who die by suicide had a diagnosis of depression at the time of their death, and 40–80% of adolescents who attempt suicide have been diagnosed with depression (Cash, 2009).
There are several contributing factors to the rise of mental health disorders in children and young people. These include childhood adversity and trauma, poverty, bullying, and the perception that one's emotions are not within one's control, among others (NHS England, 2023b; Somerville et al, 2024; Farooq et al, 2024; Graham and Maughan, 2025).
The COVID-19 pandemic has also been shown to have exacerbated the mental health crisis that was already on the rise in children and young people (YoungMinds, 2025). This led to a marked increase in antidepressant consumption among young people in the months following the pandemic onset (Valtuille et al, 2024).
Antidepressant prescribing
Antidepressant prescribing has been on the rise in young people with depression (Virtanen et al, 2024), which makes sense given the rise of mental health issues among this population. However, older-generation antidepressants, known as tricyclic antidepressants (TCAs), which were traditionally the mainstay of treatment, have shown not to be an effective treatment for depression in young people (Hetrick et al, 2021). There have also been concerns about both TCAs and selective serotonin reuptake inhibitors (SSRIs) being linked to manic switches in young people with depression (Virtanen et al, 2024).
This lack of efficacy among older treatments gave rise to the development of newer-generation antidepressants over the last couple of decades, with earlier studies showing them to be well tolerated (Hetrick et al, 2021). However, the positive effects of these treatments appear to be modest now that enough time has passed to begin reviewing them more closely, and they also appear to be associated with an increased risk of suicidal attempts and suicidal ideation (Hetrick et al, 2021).
Another issue that has been uncovered by a relatively recent report is an increase in antidepressant prescribing in young people due to GPs providing prescriptions without young people first seeing a psychiatrist (National Institute for Health and Care Research (NIHR) (2022), as recommended in guidelines from the National Institute for Health and Care Excellence (NICE) (2019). The reason for this appears to be a lack of access to mental health services or child and adolescent psychiatrists (NIHR, 2022). With 80% of young people waiting more than 4 weeks to start treatment, GPs have started prescribing antidepressants to those in urgent need (NIHR, 2022). Thousands of children and teenagers in the UK are currently taking antidepressants for depression and anxiety, without first having seen a specialist – and this number continues to rise (NIHR, 2022).
It must be noted that psychological or ‘talking’ therapies (e.g. psychotherapy, cognitive behavioural therapy) are considered to be the main and first-line therapies for children with depression or anxiety. While antidepressants can be a useful adjunct in some cases for children who are not seeing improvement with psychological therapies alone, this is controversial (NIHR, 2022).
Looking ahead
The mental health of young people was set out as a priority in the NHS long-term plan and services have been expanding as a result (NHS England, 2025). Close to 400 mental health support teams have been rolled out in schools and colleges (NHS England, 2023a). Another 200 teams are in training and are expected to become operational by this spring, which would cover more than half of the country's learners (NHS England, 2023a).
Antidepressants should only be considered once young people have had a full assessment, have seen a mental health specialist and have started on psychological therapy, and it is deemed that they require a further adjunct to their treatment (NICE, 2019).
According to Hetrick et al (2021), of the newer-generation antidepressant therapies, sertraline, escitalopram, duloxetine, as well as fluoxetine, could be considered, although the latter is currently the only treatment considered as first-line prescribing.
Sacco et al (2022) suggest that the introduction of routine screening, improving diagnostic sensitivity, raising awareness of mental health disorders, minimising socioeconomic inequality and stigma surrounding mental health, and developing early intervention services can all contribute towards improving the mental health of children and adolescents.