One in Five: Why the UK’s Growing Teen Mental Health Crisis Demands Specialist Transport
June 29, 2026
At A Glance
One in five children and young people now has a probable mental disorder, up from one in eight in 2017. CAMHS transport is not an adapted adult protocol. It is a separate discipline with a separate legal framework, separate safeguarding requirements and a different clinical picture.
- Over 270,000 young people are currently waiting for mental health support; 59% report their condition worsened during the wait
- 34,793 emergency mental health referrals for children were recorded between April and October 2024 alone, a 10% increase on the previous year
- Secure 24 runs a separate CAMHS protocol: child-specific DBS checks, CAMHS-aligned safeguarding training, gender-matched crew option, civilian clothing where uniform would increase anxiety
- Children Act 1989 obligations sit alongside the Mental Health Act 1983 for under-18 patients: a different legal framework requiring different preparation
- CQC GOOD across all service areas; 24/7 availability for planned and emergency CAMHS transport
A young person in mental health crisis is not a small adult. The legal framework governing their care is different. The safeguarding obligations are different. The clinical presentation is different. And the consequences of getting the transport leg wrong are different in kind, not just degree, from the consequences of a poorly managed adult transfer.
The transport infrastructure that connects young people to the care they have been referred to is part of the mental health system. And it is the point where specialisation has been most consistently missing. Routing under-18s through an adult transport framework with a note attached is not a CAMHS service. It is a system gap dressed as a solution.
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A National Conversation That Was Already Overdue
When Adolescence, Netflix’s four-part drama about a 13-year-old’s involvement in a violent crime, became one of the most-watched UK television events of recent years, it sparked a national conversation about the mental health of children and young people. The Prime Minister called for the series to be shown in schools. The Children’s Commissioner for England used Children’s Mental Health Week 2025 to set out the scale of what the statistics actually show.
In 2017, one in eight children and young adults were likely to experience mental health challenges. By 2023, that number had risen to one in five. Over 270,000 young people are currently waiting for mental health support. Between April and October 2024 alone, YoungMinds recorded 34,793 emergency mental health referrals for children, a 10% increase on the equivalent period the previous year. Among those waiting, 59% reported that their mental health worsened during the wait. The drama captured public attention. The underlying reality had been accumulating for years.
Why CAMHS Transport Is a Different Discipline
A separate legal framework
Children and young people detained or supported under the Mental Health Act 1983 or the Children Act 1989 carry a different set of obligations. The safeguarding responsibilities that apply to adults are present and amplified. The documentation, consent and capacity frameworks are different. A crew operating under adult mental health transport protocols is operating in a different context to the one they have been prepared for. The referring organisation’s obligations do not end at the point of handover to transport.
A different clinical picture
Young people in mental health crisis present differently to adults. Their communication is different. Their responses to authority and unfamiliar environments are different. The anxiety produced by the transport moment, being removed from family and familiar settings by strangers, is often more acute. The window for de-escalation is narrower. For a young person who has been waiting months or years for support, the transport journey is often the first moment they encounter professionals who are there specifically for them. How that moment goes matters for everything that follows.
Different safeguarding requirements
Every crew member who works with under-18 patients at Secure 24 holds a child-specific enhanced DBS clearance, not the standard adult DBS that covers the rest of our fleet. Our safeguarding training for CAMHS work is a distinct framework, separate from our adult patient protocols, aligned with the current CAMHS guidance from NHS England and local authority children’s services.
CAMHS Operations
The first minutes of contact set the tone for the whole journey
A young person who has been waiting two years for support, who has been let down by the system they were told would help them, arrives at the transport moment with a specific kind of distrust. Our crew understand this. The briefing before a CAMHS job covers the young person’s history, presentation and known triggers at the same level of preparation we apply to high-risk adult transfers. Civilian clothing removes one barrier. A genuine conversation removes another. De-escalation is not a technique we apply when things go wrong. It is how we begin every job.
What Specialist CAMHS Transport Actually Looks Like
Secure 24’s approach to young person transport is built around three operational commitments that do not exist in our adult framework as standard.
A separate protocol, not an adapted adult approach
We do not route CAMHS referrals through our adult transport framework with a note attached. The DBS checks are different. The safeguarding training is different. The crew briefing before a CAMHS job covers the young person’s specific history, presentation and known triggers. For young people with specific anxieties about uniforms or authority figures, we use civilian clothing. Gender-matched crew is standard where requested and operationally available.
Active engagement during the journey
For many young people, the ambulance journey is an unfamiliar and frightening experience. Our crew work to change that: not by minimising the clinical reality of what is happening, but by being genuinely present with the patient throughout. Board games, music, conversation about what matters to the young person, creative activities: these are the active engagement model that reduces anxiety, reduces the likelihood of escalation and makes the handover to the receiving facility from a measurably better starting point.
Coordinated handover with families and clinical teams
CAMHS transport involves more stakeholders than standard adult transfers. Parents or carers are frequently present at departure and expected at the receiving facility. CAMHS teams, local authority children’s services workers and NHS trust staff all need accurate real-time information about the journey. Our dispatch model coordinates that communication throughout: from departure to arrival, with consistent updates to all parties who need them.
Inside Our CAMHS Transport Operation
Training, crew and coordination: the three elements behind every under-18 transfer.
Want to speak to a CAMHS team or local authority children’s services lead already using Secure 24? We will arrange a peer reference call.
Why Adult Transport Protocols Do Not Transfer to Under-18s
The gap between adult mental health transport and specialist CAMHS transport runs through the safeguarding framework, the legal context, the communication approach and the vehicle environment. A young person who is distressed in transit needs de-escalation, plus the safeguarding awareness to recognise when distress signals something the adult framework does not capture: a child protection concern, a disclosure, a presentation that triggers the Children Act rather than the Mental Health Act.
Crews without that training miss those signals. Not because they are not professional, but because they have not been prepared for them. For CAMHS commissioners and local authority children’s services teams, the safeguarding audit trail, the child-specific DBS documentation and the CAMHS-aligned training certification are all available for CQC due diligence review on request. The procurement decision that matters here is not whether specialist CAMHS transport costs more. It is whether the alternative is acceptable when a young person is at their most vulnerable.
Related reading
- When a Community Is Strong, Recovery Is Possible: how specialist transport connects every transition point in the mental health pathway
- Mental Health Is Not a Crime: why NHS patients deserve purpose-built transport, not custodial vehicle design
- Ward Assist and Bed Watch: how active engagement from trained secure technicians protects patients and staff on the ward
- Section 135/136 Support: specialist conveyance under the Mental Health Act: what it looks like in practice
Were extremely friendly, very professional and very helpful. They were absolutely amazing and will probably never know how much of a difference they have made.
Service user feedback, Secure 24
March 2025
Related services
- Secure ambulance fleet: our purpose-built secure mental health transport vehicles
- Ward Assist and bed watch: trained secure technicians providing active ward supervision
Frequently asked questions
Do you have a separate protocol for transporting children and young people?
Yes. CAMHS and under-18 transport is handled through a distinct operating framework, not an adaptation of our adult protocols. Child-specific enhanced DBS checks, CAMHS-aligned safeguarding training, child-appropriate briefing and dispatch procedures, and civilian clothing options are all built into the protocol as standard.
What safeguarding checks do your staff hold?
All staff working with under-18 patients hold child-specific enhanced DBS clearances in addition to their standard adult DBS checks. Our CAMHS-aligned safeguarding training is a separate module from our adult safeguarding training, updated in line with NHS England CAMHS guidance and local authority children’s services requirements.
Can you transport young people in acute CAMHS crisis?
Yes. We provide both planned and emergency CAMHS transport. Emergency bookings are handled through our 24/7 control room: call 0330 320 1159. Our dispatch team will confirm availability, crew profile and estimated mobilisation time for your location.
How do you handle a young person who is anxious or resistant to transport?
Our crew are trained for this specifically. The first minutes of contact are the most important, and our crew are briefed on the young person’s history and presentation before arrival. Civilian clothing removes a common anxiety trigger. Active engagement: music, conversation, creative activities, begins as soon as the patient is comfortable with it. De-escalation is the first and primary tool throughout.
Do you coordinate with CAMHS teams and local authority children’s services?
Yes. Our dispatch team provides real-time updates to referring clinicians, CAMHS teams, local authority workers and family members throughout the journey. For complex multi-agency transfers, we coordinate in advance with all parties to confirm the handover protocol, communication expectations and any specific patient requirements.
Can you transport children on an emergency basis?
Yes. Our control room operates 24/7 and handles emergency CAMHS referrals. Contact us on 0330 320 1159. We will confirm availability and mobilisation time for your area. For teams with frequent CAMHS transport need, an SLA with priority dispatch is available.
Up to what age do you transport under your CAMHS protocol?
Our CAMHS protocol applies to under-18 patients, with the framework adapted to the developmental stage and presentation of the individual young person rather than applied as a single fixed approach across all ages. For young people transitioning between children’s and adult services, we coordinate with both the referring CAMHS team and the receiving service to confirm which framework and safeguarding obligations apply before the journey.
Can a parent or carer travel with the young person?
In most cases, yes, where the clinical team and the crew agree it supports the young person and does not compromise safety. A familiar adult present can significantly reduce a young person’s anxiety during transport. Where a parent or carer cannot travel in the vehicle, our dispatch team keeps them updated throughout the journey and confirms arrangements for them to meet the young person at the receiving facility.
Building the business case?
Procurement pack: CQC report, RISKA training framework, fleet specifications, sample SLA.
