Mental healthcare in the UK

Looking after your mental health is vital at all times. But it is perhaps even more important when you have relocated to an unfamiliar country. Luckily, if you are moving to the UK, there is a myriad of services available for those who need help. The National Health Service (NHS) provides free mental healthcare and there are numerous charities and support groups to call on. That said, the impacts of the COVID-19 pandemic on mental health and wellbeing have placed those services under severe stress. As a result, waiting lists for some NHS services are at, or close, to crisis point.

Nevertheless, this article provides all the information you need to find help, treatment, and advice, including the following:

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Mental health in the UK

According to the health charity Mind, a quarter of adults in the UK experience a mental health problem of some kind each year. Furthermore, the latest Survey of Mental Health and Wellbeing in England found that one in six people aged over 16 had experienced symptoms of a common mental health problem, such as depression or anxiety, in the past week. The survey also claimed that women were more likely than men to experience common mental disorders.

In response, the UK devotes huge resources to the issue. In fact, about 15% of England’s total health spending was on mental health, learning disability, and dementia in 2020/21. A UK Parliament report also put mental health spending in England at £14.3 billion, up from £12 billion in 2017/18.

Suicide rates in the UK

Despite this, suicide is the leading cause of death for people aged 24 to 30 in England and Wales. In 2020, there were 5,224 suicides in England and Wales, which equates to 10.0 deaths per 100,000 people. However, this is a lower rate than 2019 and lower still than in the 1980s and 1990s.

International comparisons show that suicide is less prevalent in the UK (7.9 per 100,000 people) than in other European and Central Asian countries (12.8 per 100,000 people). In Europe, only a small handful of countries have a lower suicide rate (including Italy, Spain, and Türkiye). By comparison, Lithuania (26.1 per 100,000 people) and Russia (25.1 per 100,000 people) have the highest suicide rates in Europe.

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UK charity The Mental Health Foundation claims that despite high-profile education campaigns, people with mental health problems still suffer from stigma and discrimination. As a result, there can be a reluctance to seek help. There are strong links between ill mental health and social isolation, loneliness, poverty, and unemployment, the foundation says. And although the number receiving treatment has increased significantly, it estimates that up to 75% of people in England may not get access to the treatment they need.

Mental healthcare services in the UK

The NHS is responsible for providing and coordinating mental healthcare services. These are free to all residents. You can read more about how the UK’s tax-funded healthcare system works and how expats can use it in our article on healthcare in the UK.

You can usually access help with a referral from a General Practitioner (GP). The NHS provides an online guide to getting access to a range of therapies and support services including those run by mental health charities, local authorities, and volunteers. The mental health charity Mind is another useful source of information about the ways people can find help in their communities.

How to access mental health services in the UK

Expats and temporary residents can register for healthcare from the NHS. This includes mental health services. You can find more information about how to register with a GP at a doctor’s surgery on the NHS website.

Since 2015, those coming to the UK from outside the EU/EEA/Switzerland for more than six months have to pay a health surcharge of at least £150-200. If you are a third-country national who has paid the surcharge, you can access NHS services on the same basis as everyone else. However, if you haven’t paid and don’t have any medical insurance, then you’ll be charged at 150% of the standard NHS tariff for any care you receive; unless you’re from a country that has a reciprocal healthcare agreement with the UK or qualify for an exemption.

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Health insurance in the UK

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Nationals from outside the EU/EEA/Switzerland can access the NHS for free on the same basis as British citizens if they have settled in the UK and been given indefinite leave to remain. Other non-EU/EFTA nationals can access services such as emergency treatment and family planning services free of charge. However, they will need to take out health insurance to access other services.

Notably, people visiting the UK from a European Economic Area (EEA) country or Switzerland currently get free NHS care by using their European Health Insurance Card (EHIC).

Doctor referrals

Your GP will refer you to a psychologist, psychiatrist, or another specialist if necessary. However, you can self-refer for some treatments with psychologists and other therapists including:

• drug and alcohol addictions
• psychological therapies for anxiety and depression
• agoraphobia
• obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD)

You can find NHS psychological therapies available without a GP referral on the NHS website. Just bear in mind that while you can contact therapists directly to seek help, you will first need to register with a GP.

NHS mental health services are under severe strain, which is partly a result of the COVID-19 pandemic. According to The Guardian newspaper, in August 2021, an estimated eight million people in England could not get the specialist care they needed.

Insurance for mental healthcare in the UK

Although the full range of mental healthcare services is free on the NHS, waiting lists for treatment can be lengthy. However, you can avoid queues by going to private providers.

Medical insurance comparison site Healthcare Clarity says that many providers cover the cost of mental health services. Some include it as standard but most add it at an extra cost. And for greater protection, you will need to pay more as some specialist mental health services are expensive. Premiums will vary depending on age, location, and lifestyle as well as pre-existing diagnoses for mental health problems.

Some of the leading private health insurance providers in the UK include:

• Allianz Care
• Cigna Global

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It is possible to get cover for:

• Private psychologists, counsellors, and psychiatrists
• Mental health assessments
• Access to 24-hour support
• Tailored treatment plans
• Rehabilitation services, such as counselling and cognitive behavioural therapy

Psychologists, psychiatrists, and therapists in the UK

You will need a GP referral to access some specialist mental health services in the UK. And a mental health assessment may be necessary to direct you to the most appropriate professional help.

You must also have a GP referral to see a psychiatrist. These are specialists who can prescribe drugs to treat mental health problems including:

• anxiety
• phobias
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)
• personality disorders
• schizophrenia
• depression and bipolar disorder
• dementia and Alzheimer’s disease
• eating disorders, such as anorexia and bulimia
• sleep disorders, such as insomnia
• addictions, such as drug or alcohol misuse

It is worth noting that while psychologists and other NHS therapists are able to use techniques to help with some of these issues, they are not able to prescribe drugs.

Patients have the right to choose their provider and clinical team and can compare mental health service providers using the services near you search tool. You simply need to enter the name of the mental health service or the service provider and your postcode. According to the NHS, it shouldn’t take longer than 18 weeks to receive consultant-led mental health services.

How to find psychiatric services and therapy

Mind has an excellent independent guide to finding therapists in the NHS, through charities and support groups, and in private practice. The guide includes links to organizations outside the NHS that provide free or low-cost talking therapies. However, it warns that you might face a long waiting list for NHS treatment.

The Royal College of Psychiatrists has warned that there simply aren’t enough qualified psychiatrists in the UK to meet demand. Official NHS workforce data shows that there are 4,500 full-time consultant psychiatrists for 56.5 million people, which equates to one consultant per 12,567.

Addictions, eating disorders, and child and adolescent psychiatry have the highest vacancy rates, even though the numbers of those needing support from these specialties are overwhelmingly high.

Professional bodies

Private therapists are available, but Mind suggests using only those who are registered with a professional body such as:

• Counselling Directory – for all kinds of counsellors and therapists
• British Association for Counselling and Psychotherapy (BACP) – for all kinds of counsellors and therapists
• British Association for Behavioural & Cognitive Psychotherapies (BABCP) – for cognitive behavioural therapy (CBT) practitioners
• UK Council for Psychotherapy (UKCP) – for psychotherapists
• British Psychological Society (BPS) – for local therapists
• Pink therapy – for therapists with LGBTQ+ experience

If you choose to go private, Psychiatry-UK says that an initial one-hour consultation costs £360, and each minute of subsequent consultation is £6. It is a good idea to check with the therapist first to find out how much a course of treatment will cost, including the price of prescribed medication.

Drug and alcohol addiction services in the UK

Treatment for drug and alcohol addiction is available on the NHS and through a wide variety of charity-supported organizations. As with any other health-related issue, your GP is a good place to start.

GPs can offer treatment for drug-related problems either at their surgery or at a local NHS drug service. However, it is possible to self-refer or seek help from one of the many self-help and support agencies. You can visit the Frank website to find local drug treatment services. Treatment will depend on your personal circumstances and could include detoxification or treatment with medicines.

You may have your treatment while living at home or as a hospital inpatient. However, if your problems are severe or complicated, you may be referred to a residential rehabilitation service. For more information or to find a rehab near you, you can visit rehabonline.

In the UK, alcohol misuse can be treated on the NHS with counseling or medicines. Librium is used to stop alcoholics from suffering withdrawal symptoms. Drugs such as acamprosate and naltrexone also reduce the urge to drink.

Support groups

It is common for problem drinkers to be directed to support agencies such as:

• Drinkline – the national alcohol helpline. You can call this free helpline in confidence if you’re worried about your own or someone else’s drinking. You can call 0300 123 1110 on weekdays from 09:00 to 20:00 and weekends from 11:00 to 16:00.
• Alcoholics Anonymous (AA) – a free self-help group that offers a 12-step program that involves getting sober with the help of regular support groups
• Al-Anon Family Groups – offers support and understanding to the families and friends of problem drinkers, whether they’re still drinking or not. Alateen, part of Al-Anon, can be attended by 12- to 17-year-olds who are affected by another person’s drinking, usually a parent.
• We Are With You – a UK-wide treatment agency that helps individuals, families, and communities manage the effects of drug and alcohol misuse. If you are over 50 and worried about your drinking, you can call 0808 8010 750.
• Adfam – a national charity working with families affected by drugs and alcohol. Adfam operates an online message board and a database of local support groups.
• The National Association for Children of Alcoholics (Nacoa) – provides a free, confidential telephone and email helpline for children of alcohol-dependent parents and others concerned about their welfare. You can call 0800 358 3456 for the Nacoa helpline.
• SMART Recovery – their groups help people decide whether they have a problem, build up their motivation to change, and offer a set of proven tools and techniques to support recovery.

You can also find alcohol support services in your area on the NHS website.

Private rehab

Private rehab for drink and drug addictions is also an option in the UK. However, the costs can be high and might not be covered by some private health insurance policies. For example, UK Rehab says that a 28-day program will cost somewhere between £6,950 and £11,950. Meanwhile, Help4addiction advises that rehab costs range from £1,500 to £5,000 a week depending on the facilities.

Services dealing with eating disorders in the UK

It is estimated that 1.25 million people in the UK have an eating disorder. These disorders are considered to be serious mental health problems with potentially severe psychological, physical, and social consequences.

Although they are often associated with teenage girls, anyone can develop a disorder around certain foods, body image, and weight. The most common disorders are:

• Anorexia nervosa – trying to keep your weight as low as possible (for example, by not eating enough or over-exercising). You may have a distorted view of your body, thinking you’re larger than you are.
• Bulimia nervosa – having an unhealthy cycle of eating a lot of food and then doing something to try to stop weight gain, such as vomiting or taking laxatives
• Binge eating – where you eat a lot of food in a short period of time on a regular basis. As with bulimia, you won’t feel in control of your eating.

The NHS treats all eating disorders. As with most physical and mental health issues, GPs are able to help and may refer patients to a local NHS eating disorder team.

Where to find support and advice

Most people will be offered individual therapy and those with binge eating disorders may be offered group therapy. These links are useful:

• BEAT – provides support and advice via their helpline as well as online resources about eating disorders
• The National Centre for Eating Disorders – provides resources for people with eating disorders and training for professionals
• Talk ED – provides ongoing care and support and practical guidance for people with eating disorders and their parents, families, and friends
• You can also talk in confidence to an adviser from eating disorders charity Beat by calling their adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711

The NHS aims to start treatment for teenagers within one week of assessment in severe cases and four weeks in non-urgent cases. However, the Nuffield Trust says that these targets are often missed. Waiting times have grown as demand has increased during the COVID-19 pandemic. For instance, Beat claims that adults in some parts of the UK are waiting 10 times longer for treatment than in other areas. As with other mental health problems, there are plenty of private treatment options for those who are willing and able to pay.

How much it might cost

Costs vary, but UK Rehab’s pricelist for London and the southeast is as follows:

• Clinical report: £45
• CPA meeting with two clinical staff: £189
• Initial assessment for eating disorders: £189
• Eating disorder nurse specialist: £80 per hour
• Therapeutic support worker: £25 per hour
• CBT: £100 per hour
• DBT: £100 per hour
• Clinical psychologist: £120 per hour
• Dietician specialist: £80 per hour
• Family therapy: £80 per hour
• Hypnotherapist: £80 per hour
• IPT: £80 per hour
• Six-week group therapy courses: £295 (30)

Mental healthcare in the UK for people with severe mental health problems

There are a number of services up to and including treatment in a hospital for those with severe mental problems in the UK. Most hospital admissions are voluntary. That said, people can be detained and treated under the Mental Health Act 1983 (in England and Wales) if they are judged to be a risk of harm to themselves and others. This is known as “being sectioned“. Notably, patients can only be sectioned after assessment by a team of health professionals.

Those who have been sectioned normally get help from an Independent Mental Health Advocate (IMHA) who challenges their detention and ensures that their legal rights are not ignored. The advocate also advises on how to be discharged from the hospital and get the section lifted. In October 2021, The Evening Standard newspaper reported a rise in the number of people being sectioned in England. It said more than 53,000 in 2020 had been detained under the Mental Health Act and that campaigners were worried that not enough was being done to effectively treat people before they reached crisis point.

People identified as in need of more detailed and specialized care are referred in the first instance to community mental health teams. These teams may include a community psychiatric nurse (CPN), a psychologist, an occupational therapist, a counselor, and a community support worker, as well as a social worker. Care coordinators may be assigned to the patient as a regular point of contact. Doctors may also ask local authority social services to assist the patient with day-to-day tasks and managing money.

Residential options

Residential care is an option for those who are unable to cope in the community, and this includes:

• Hostels – short-term accommodation, with supervision, to help patients until they can live more independently
• Residential care homes – these offer a much higher level of support for people with severe mental health problems
• Therapeutic communities – these are for short stays, with group or individual therapy as part of rehabilitation programs
• Supported housing schemes – these enable patients to live independently, in furnished accommodation, with the back-up of a mental health support worker

Waiting lists vary at different locations throughout the UK, but the NHS aims to provide consultant-led care within 18 weeks of an assessment.

Support for children and young people in the UK

According to the Local Government Association (LGA), at least one in six children and young people in the UK had a diagnosable mental health condition in January 2022. Furthermore, more than 4,000 children were admitted to inpatient mental health care in 2019–2020. Emotional disorders, particularly anxiety, and depression increased during the COVID-19 lockdowns and movement restrictions. The LGA also identifies online bullying as another strain on the emotional health of young people.

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The NHS has established pathways to treatment for children with mental health problems. This includes providing general advice to parents about spotting signs, support organizations, and how to seek professional help.

Support through the NHS

Parents, carers, and young people can receive direct support through NHS children and young people’s mental health services (CYPMHS). Local and regional teams provide access to the following:

• psychiatrists
• psychologists
• social workers
• nurses
• support workers
• occupational therapists
• psychological therapists – this may include child psychotherapists, family psychotherapists, play therapists, and creative art therapists
• primary mental health workers
• education mental health practitioners – who work in mental health support teams in schools and colleges
• children’s wellbeing practitioners
• specialist substance misuse workers

Getting help from a specialist CYPMHS is different depending on where you live. Waiting times can vary too. Most CYPMHS have their own website with information about access and referrals. You can also look at your local Clinical Commissioning Group (CCG) website and search for children and young people’s mental health.

Voluntary community-based support

There are many services providing help without a referral, including crisis helplines that anyone can call. You can read about where to get urgent help for mental health on the NHS website. Voluntary community-based youth information services often have drop-in sessions for advice and professional help. The Anna Freud National Centre for Children and Families website has information and a video about how young people receive support from mental health services. The Royal College of Psychiatrists website also provides material about who’s who in CAMHS, and offers information for parents and young people.

Some, but not all, schools have mental health support teams (MHSTs) or dedicated counselors. In March 2021, the UK government announced  £79 million to boost mental health support for children and young people in England. It will be used to expand support. The aim is to increase the number of schools with MHSTs and cut waiting times for community support.

Mental healthcare services for special groups in the UK

According to the Mental Health Foundation, one in five UK women has a common mental health problem such as anxiety, depression, or self-harm. The issue is recognized by the UK government. In 2018, a major government task force report made a list of recommendations to improve mental healthcare for women.

Problems impacting the mental health of women include domestic and sexual violence, stress from being a carer, menopause, perinatal depression, and pressures around body image. As a result, there are some services aimed specifically at women. GPs can refer patients to specialized services and support groups such as the PANDAS Foundation. This offers specific support to women with postnatal depression. Mind also has a range of programs for women.

There is also a specific provision for lesbian, gay, bisexual, trans, and queer people. The mental health service MindOut works to improve the mental health of all LGBTQ communities and has a nationwide online service. Mind also has guidance for LGBTQ and people struggling with their sexuality and links to organizations that can help.

There are also support groups for people with disabilities who are struggling with their mental health. Support line provides links to numerous organizations.

Prevention and education programs in the UK

The NHS has a proactive role in advising people on how to improve their mental health and wellbeing. In addition, the Mental Health Foundation hosts Mental Health Awareness Week in May each year. The event has run for 21 years and has become one of the biggest awareness campaigns in the country. Previous themes have included kindness, body image, and reconnecting with nature. In 2022, it tackles loneliness and its impact. Campaigning organizations such as Mind support awareness week.

Many of the charities that provide support to sufferers run their own awareness campaigns. For example, SANE, which also runs a crisis helpline, has a Black Dog Campaign to highlight awareness of depression.

There are many local initiatives for those who recognize the importance of protecting their mental health. For instance, doctors’ surgeries and public libraries often have information and contact details about local activities that promote well-being. You can also search the internet for activities nearby. Some local mindfulness groups charge for sessions and classes, such as the Nottingham Mindfulness Group which charges £5 per session for its weekly meetings and up to £85 for some weekend workshops.

Emergency support and crisis lines in the UK

If you need urgent assistance, the NHS provides details of what to do in a crisis. You can also find localized assistance on its website.

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Emergency phone numbers in the UK

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If someone’s life is in immediate danger, you should call 999 to connect to police and ambulance services. Alternatively, you can go straight to the nearest Accident and Emergency (A & E) department at a hospital. These departments will treat any physical symptoms and will alert mental health teams.

Crisis support contacts in the UK

Mind provides a full guide to helplines and services that provide crisis support to those in need. Here are some other helplines you can call:

General helplines in the UK

• Samaritans – To talk about anything that is upsetting you, you can contact Samaritans 24 hours a day, 365 days a year. You can call 116 123 (free from any phone), email [email protected], or visit some branches in person. You can also call the Samaritans Welsh Language Line on 0808 164 0123 (19:00-23:00 every day).
• SANEline – If you’re experiencing a mental health problem or supporting someone else, you can call SANEline on 0300 304 7000 (16:30–22.30 every day).
• National Suicide Prevention Helpline UK – Offers a supportive listening service to anyone with thoughts of suicide. You can call the National Suicide Prevention Helpline UK on 0800 689 5652 (open 24/7).
• Campaign Against Living Miserably (CALM) – You can call CALM on 0800 58 58 58 (17:00–midnight every day) if you are struggling and need to talk. Or if you prefer not to speak on the phone, you could try the CALM webchat service.
• Helplines Partnership – For more options, visit the Helplines Partnership website for a directory of UK helplines. Mind’s Infoline can also help you find services that can support you. If you’re outside the UK, the Befrienders Worldwide website has a tool to search by country for emotional support helplines around the world.

Age-specific helplines in the UK

• The Mix – If you’re under 25, you can call The Mix on 0808 808 4994 (15:00–midnight every day), request support by email using this form on The Mix website, or use their crisis text messenger service.
• Papyrus HOPELINEUK – If you’re under 35 and struggling with suicidal feelings, or concerned about a young person who might be struggling, you can call Papyrus HOPELINEUK on 0800 068 4141 (weekdays 10:00-22:00, weekends 14:00-22:00 and bank holidays 14:00–22:00), email [email protected], or text 07786 209 697.
• Nightline – If you’re a student, you can look on the Nightline website to see if your university or college offers a night-time listening service. Nightline phone operators are all students too.

LGBT+ helplines in the UK

• Switchboard – If you identify as gay, lesbian, bisexual, or transgender, you can call Switchboard on 0300 330 0630 (10:00–22:00 every day), email [email protected], or use their webchat service. Phone operators all identify as LGBT+.

Useful resources

• NHS UK – offers information on where to get urgent help for mental health
• NHS UK – provides information and support for your mental health
• Samaritans – the official website with hotline information
• Mind – information on crisis services and planning for a crisis
• 988 Suicide and Crisis Lifeline – provides 24/7, free, and confidential support for people in distress, prevention, and crisis resources