Referrals to children’s mental health services decline after sharp rise in recent years 

The number of children referred to mental health services has dipped after years of sharp increases, with a further projected reduction this year. 

The drop need not mean reduced need but is more likely due to effective early intervention. 

GHA data suggests a “modest projected reduction” in referrals this year to Gibraltar Young Minds (GYM) of approximately 10% when compared to last year. 

Data from the GHA shows that in 2019 there were 110 referrals, dropping to 48 in 2020 due to pandemic disruption before rising again in 2021 to pre-pandemic levels with 113 cases referred that year. 

In 2022, referrals more than doubled to 283 and a year later in 2023 increased again to 295 referrals. 

But, in 2024, referrals reduced to 230 children. 

 So far this year, 155 children and adolescents have been referred. 

"While it is too early to draw firm conclusions about consistent patterns in referral rates, given that the service is still relatively new, we continue to strengthen our collaboration with partners, including the Department of Education and the Care Agency, as well as charities such as Childline,” a Government spokesperson said.  

“This context means that across the whole system, joint working has an increased emphasis on early intervention and prevention.” 

“It is important to note that a lower number of referrals does not necessarily indicate a reduced level of need.” 

“On the contrary, it may reflect more effective early intervention and improved allocation of resources across the system, enabling GYM to focus on children and young people with the most complex needs.” 

 According to the Government, the most common reasons for referral to GYM have remained consistent in recent years.  

Referrals are frequently related to mental health difficulties such as anxiety, self-harm, school avoidance and eating disorders.  

“Behavioural challenges are also a regular theme, with many families seeking guidance and support in managing their child’s behaviour,” the spokesperson said. 

“In addition, a significant proportion of referrals concern neurodevelopmental issues, particularly requests for ADHD assessment and medication.” 

“The service also works with children and young people with autism spectrum disorder accompanied by concerns around anxiety or other mental health difficulties.” 

The current waiting times are approximately 26 weeks to see a psychiatrist, around 33 weeks to see a psychologist, and about 25 weeks for counselling.  

While on the waiting list, some children and young people receive interim support from the Gibraltar Young Minds nursing team, which provides monitoring and therapeutic support.  

The Government spokesperson said all referrals are reviewed by a full multi-disciplinary team before being accepted or placed on a waiting list. 

The spokesperson added that the number of children and young people seen by GYM each week varies depending on clinical need, term times and the nature of the interventions provided.  

“On average GYM sees around 65 children and young people per week across the team,” the spokesperson said. 

“In addition, the nursing team monitors a caseload of patients for medication reviews and this may vary in frequency depending on clinical need.” 

 There are three part-time psychiatrists working in GYM, two based in Gibraltar and one child psychiatrist working remotely from the UK.  

Consultations are conducted both remotely and through face-to-face clinics held every quarter.  

“Currently, there are 2.1 whole-time equivalent clinical psychologist posts at GYM, reflecting a recent increase in capacity thanks to additional funding granted from mid-September 2025 to mid-January 2026,” the spokesperson said. 

The team includes one part-time assistant psychologist, one registered mental health nurse, and two enrolled nurses.