Children with mental health problems must be severely unwell before they can get help at NHS trusts across England, an investigation has found.

Data obtained via freedom of information requests shows a third of mental health trusts only accept patients with “severe” or “significant” conditions for specialist child and adolescent mental health services.

The research conducted by Pulse – a specialist publication for doctors – analysed data on referral criteria used by 29 of the 56 facilities in England. Just one in five (six NHS mental health trusts) accept referrals for children with all levels of conditions.

Dr Bernadka Dubicka, the chair of the Faculty of Child and Adolescent Psychiatry at the Royal College of Psychiatrists, said the situation for many young people was “stark”.

“Nearly one in four older teenage girls have a mental health disorder and half of those have self-harmed. What we are seeing is the result of increasing demand, historical under-investment and a growing workforce crisis,” she said.

“There are many children and young people with mental illness who urgently need help now.”

Emma Thomas, the chief executive of the mental health charity YoungMinds, described the findings as worrying. “Thresholds for treatment are often too high, which means that young people who need urgent help simply can’t get it. We hear time and again on our helpline from desperate parents whose children are self-harming or too anxious to go to school, and who just don’t know where to turn,” she said.

Pulse sent out freedom of information requests to all 56 NHS mental health trusts in England about the criteria they use for referrals, plus three other health trusts that provide these services in certain regions.

Pulse received responses from 23 NHS mental health trusts with comparable data, and retrieved comparable information for a further six from their websites.

A Pulse survey of 935 GPs found nearly 30% said criteria for adolescent mental health services (CAMHS) referrals have become stricter in the past year.

The lack of NHS specialist treatment on offer means people experiencing problems are often told to seek help from charities instead, but these services often offer help from counsellors as opposed to doctors.

GPs have warned that children are being forced to wait until their condition escalates before being seen by a specialist. Referrals for children’s mental health services are rising – up by 18% between 2017-18 and 2018-19.

﻿Dr Maddi Ridley, a GP in Essex, said: “Referrals come back saying they don’t meet the criteria and suggesting where the child or adult can get support locally from counselling services run by charities.

She added: “We’ve seen quite a number of deaths by suicide in teenage children in our area. Children are really struggling with mental health and we don’t have a lot to offer. For instance, the waiting list for counselling is 18 months.

“These children do need professional help, there just doesn’t seem to be any facilities available within the NHS.”

An NHS England spokesperson said: “This data is based on less than half of all mental health trusts and does not include other NHS-funded organisations that provide mental health support.

“The NHS is actually ahead of its target on ensuring as many children as possible receive mental health care, and the long-term plan has committed to ensuring an extra 345,000 children and young people get the care they need by 2023, backed by extra funding for mental health services of more than £2bn.”