OBJECTIVE: This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders. METHODS: In this hospital-based retrospective study, we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders (schizophrenia, depressive episode, bipolar disorder, pervasive developmental disorder, and unspecified mood disorder) that accounted for the overall proportion of patients admitted. The rank and proportion of these mental disorders, demographic characteristics and disease indicators were analysed. RESULTS: There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years, with a sharp decline in 2020 due to the COVID-19 pandemic, followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022. The average age of hospitalization decreased significantly from 20.7 to 16.2 years, with a marked increase in the 12-17-year-old age group. The proportion of female hospitalizations increased from 39.2% to 55.2%, with a corresponding decrease in male hospitalizations. There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position. CONCLUSION: This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.