Lord Darzi has published a report with his findings from his review into England's NHS, which was commissioned by the Government to gain an understanding of the NHS at the beginning of their tenure. The review and subsequent report production were done rapidly, but the Society is very pleased to have been able to gather evidence in time to contribute to the report. We are acknowledged on page 140.
The report itself paints a bleak picture, but not a surprising one: waiting lists for mental health services have surged to over a million people, and children and young people are particularly affected. This is something we already well know.
There were 345,000 referrals where people are waiting more than a year for first contact with mental health services, 109,000 of which were for CYP under 18, according to the report. These figures are appalling, and it's clear that the NHS cannot meet the mental health needs of the nation without better utilising counsellors and psychotherapists. There needn't be such a waiting list; the workforce is here, and ready to help. There are no additional costs for training, and no wait while practitioners get trained up.
One of the key findings of the Darzi review is that mental health services have not expanded quickly enough to meet the demand. The NCPS’ own research reflects this, as it shows that almost 70% of our members in private practice have seen clients who turned to private therapy because NHS waiting lists were too long. This creates a two-tier system, where those who can afford private care receive timely support, while others are left waiting.
How Can Counselling & Psychotherapy Help?
Our Direct Access to Counselling campaign offers a simple and effective solution to reduce waiting lists by calling on qualified therapists, whilst also improving the quality of care by giving patients more autonomy and choice in the mental health support they receive.
At the moment, too many people are stuck waiting for help that isn’t coming fast enough. Allowing direct access to accredited counsellors and psychotherapists by giving people access to their own budget for mental health support (similar to Personal Health Budgets), would not only empower patients but also help reduce the strain on NHS services, and let people get help much quicker. Research shows time and again that recovery rates can be significantly improved if people are given timely access to the right support. It can even help reduce demand on more intensive medical interventions by providing support early.
Our survey data shows that many of our members see clients who first tried to access NHS support, only to face lengthy delays. By increasing the availability of counselling and psychotherapy through direct access, we can address this inequity and reduce the number of people forced into the private sector simply because the public system is overwhelmed. For those who can't afford to access therapy privately, we're risking their mental health worsening and the potential eventual use of significantly more costly crisis services.
Recovery rates for NHS talking therapies hover around 50%, a figure that hasn’t budged for years. We know, however, from decades of research that therapeutic outcomes improve when clients can choose their therapist and build a strong therapeutic relationships (alliance) - which is exactly what counsellors & psychotherapists are trained to do.
The Darzi review rightly points out that mental health services, amongst others, must evolve to meet the changing needs of the population. As part of that evolution, we would like to see the vast, under-utilised workforce of counsellors and psychotherapists on accredited registers being drawn on in an integrated, policy-driven way. The UK has more than 70,000 trained therapists ready to help, yet the current system funnels most mental health care through NHS Talking Therapies and only a few modalities (types of therapy), exacerbating bottlenecks and delaying support. Only 6% of the NHS Talking Therapies workforce are trained counsellors, and a mere 2% are psychotherapists. The majority are Psychological Wellbeing Practitioners and NHS trained CBT practitioners, who do not offer the same type or level of support as trained counsellors & psychotherapists.
It’s clear that the NHS cannot continue to meet the nation’s mental health needs without reform. Waiting lists won't shrink on their own, and throwing more resources at the current system isn’t a long-term solution. We need to change the way we think about our services, at the root.
The Darzi review emphasises the need for innovation and change across the board, and we believe that better integrating counsellors and psychotherapists into NHS pathways is one of the most effective ways to do that. By giving patients direct access to counselling and psychotherapy, we not only reduce waiting lists but also improve outcomes. It’s time for policymakers to recognise the potential of our workforce and make the changes necessary to ensure that everyone, regardless of income, can access the mental health support they need.
