Referrals to child mental health units from UK primary schools for pupils aged 11 and under have risen by nearly 50% in three years, the BBC has learned.
Replies to Freedom of Information (FOI) requests from 46 health trusts indicate they rose from 21,125 to 31,531.
Seven trusts said they had rejected an individual pupil for treatment at least five times over the last four years.
The government says it is “determined to improve mental health support”.
The figures, which are across the UK, are ‘deeply worrying’, say the .
Pupils had also spent more than a year on a waiting list for mental health services at 12 different trusts.