The Government has set out its vision for NHS reform, promising to cut waiting times, shift care closer to communities, and place a stronger focus on prevention. On the surface, these are welcome priorities, and there's an opportunity for counselling & psychotherapy to play a key role here. But the big questions yet remain: how will these ambitions translate into real change for mental health services? And will the necessary investment follow to make them work in practice?
There's a clear commitment to moving care out of hospitals and into the community, and this is something we strongly support. We know that timely access to mental health support is really important, and accredited counsellors and psychotherapists are already well-placed to do this. If the Government is serious about tackling the backlog and reducing pressure on NHS services, then expanding access to broader mental health support should be a key part of the solution, given what we know about the role that mental and physical health have on one another.
The emphasis on prevention is another positive step, but, again, prevention isn’t just about physical health. As we know, the earlier people receive support, the less likely they are to reach crisis point. We need to see clear commitments to ensuring that mental health services are available before issues escalate, not after, which includes offering people more choice in the type of therapy they receive and who they work with, rather than relying on a rigid, one-size-fits-all model that prioritises standardised interventions over what people actually need. Research consistently shows that the therapeutic relationship is one of the most significant factors in successful outcomes in therapy, yet current NHS models often overlook this in favour of systems designed for efficiency and data capture rather than effectiveness. We should be empowering patients with more choice over the type of therapy they receive and who they work with, rather than forcing them into a rigid, one-size-fits-all system, and utilising the huge workforce in counsellors & psychotherapists that's already available to make sure they can see someone promptly, when they need to.
Another point of note for us is the lack of urgency around mental health waiting lists. The mandate prioritises reducing waits for elective physical health treatments, but there is no equivalent commitment to tackling mental health backlogs. Over a million people are currently waiting for mental health support in England - why isn’t this seen as equally urgent? We can't continue to treat mental and physical health as separate, with one given priority over the other. If we truly want to move towards ‘parity of esteem’, mental health services must be included in the push to cut waiting times, and that means recognising the role that accredited counsellors and psychotherapists could play in delivering faster, high-quality care.
Probably the key issue for our profession, and for the public, is that we need to be mindful of the growing push towards digital solutions. While there's a place for technology in healthcare, particularly in improving access and streamlining services, it mustn't replace the fundamental human connection that makes therapy effective. The rise of AI-driven mental health support and digital therapy platforms raises important questions about safeguarding, ethical practice, and the limitations of technology in addressing complex human experiences. As the Government leans into digital transformation, we must ensure that mental health services maintain a sufficient working level of relational, face-to-face support, which should be available to all who need it.
And finally, of course, the perennial issue of funding. The NHS is expected to improve efficiency and productivity while "living within its means", but what does this mean for mental health care? While we welcome the commitment to expanding crisis support, crisis care alone is not enough - in fact, it's putting all of the funding at the wrong end. Expecting that we're unlikely to see ample funding for everything we need to achieve, this feels slightly like throwing good money after bad. Without additional investment in early intervention and community-based therapy, the pressure on crisis services will only continue to grow. The Government can't really expect to reduce demand for hospital care without strengthening the services that prevent people from reaching crisis point in the first place.
Ultimately, there is a clear opportunity for the Society to ensure that counselling & psychotherapy are once again recognised as essential parts of the mental health system. But without the right funding and infrastructure, mental health support will continue to struggle. As this mandate is put into action, we’ll be monitoring its impact closely, and we'll continue to push for better recognition of counselling & psychotherapy within the public sector ecosystem, and hopefully ameliorate some of these issues.
