By Dr Patapia Tzotzoli, Clinical Psychologist
A System at Breaking Point
The UK is facing a mental health crisis. More than 1.6 million people are currently stuck on waiting lists for mental health services, with many waiting over 18 months to receive treatment. This is against a backdrop where 1 in 4 adults will experience a mental health issue in a year.
Among young people, the statistics are even more alarming: 25.8% of 16–24-year-olds reported a mental health problem in 2024, compared to 18.9% a decade ago. Despite increasing awareness, the infrastructure to support those in need remains outdated, overstretched, and fragmented.
Why Are So Many People Falling Through the Gaps?
Having worked as a clinical psychologist for over 20 years in both the NHS and private sectors, I have seen the same issue arise time and time again: people in distress often don’t know where to go, what help they need, or how to access it.
While the NHS does provide structured referral pathways via GPs, crisis teams, and mental health practitioners, to help guide patients toward appropriate care, significant challenges remain. Regional variations in service availability mean that not every Trust has the same depth or range of services to match patients with the most suitable professionals. Even when the right therapy is identified, options are limited, and patients are often signposted to the next available therapist rather than the best match for their needs. Moreover, the NHS tends to focus on short-term, focused treatments like CBT, which can exclude alternative therapeutic models such as long-term psychodynamic therapy. Navigating the NHS system can feel fragmented; despite clinical triage, patients sometimes bounce between services, are told they don’t meet criteria, or face long waiting lists due to capacity limits. This complexity often leaves people feeling lost and unsupported.
Even private mental health care has barriers. Wait times, although often shorter than in the NHS, vary widely among professionals or clinics, and availability is concentrated in urban areas, leaving rural communities with limited choice. Clinical competence is also inconsistent; some independent providers are either not eligible, or choose not to register with a regulatory body and are therefore not required to adhere to the same standards of proficiency, conduct, ethics, and continuing professional development as other professionals. High costs put some services out of reach for many. Continuity of care can be disrupted if patients cannot afford long-term treatment, and insurance coverage is often restricted, excluding certain assessments or therapies. These factors leave patients uncertain about accessing reliable, high-standard care outside the NHS.
The average wait for a second NHS Talking Therapies appointment is now 62.5 days, but in some areas, it’s significantly longer. And while they wait, 80% of individuals report a worsening of their symptoms.
Yet, unlike physical health, where triage, diagnosis, and referral are streamlined, mental health patients are too often expected to self-diagnose, sift through an overwhelming array of options, and somehow find their way to the right support.
Mismatched Support, Delayed Recovery
Mental health is not one-size-fits-all. What works for one person – be it CBT, EMDR, or trauma-informed therapy, may be ineffective or even counterproductive for someone else. Yet we often funnel people into standardised programmes, without considering whether the approach, therapist, or timing is right for them. People seeking mental health support must be connected to the most appropriate clinician for their needs, fast.
When therapy isn’t tailored, people are more likely to disengage or drop out. Some never return to treatment. Others deteriorate further while waiting for a more suitable alternative. In these cases, the window for early intervention is often lost, to be replaced by costlier crisis management and long-term impacts.
Confusion Isn’t Compassionate
Would we ever ask a person experiencing chest pain to Google symptoms and choose a cardiologist based on their postcode? Absolutely not. Yet we ask exactly that of people in psychological distress. The absence of guided support creates a system that is confusing at best, and dangerously inaccessible at worst.
The consequences are not just personal; they are societal. The Centre for Mental Health estimates that delays in accessing the right care could cost the UK up to £8 billion a year in lost productivity, absenteeism, and increased reliance on emergency services.
The Case for Expert-Led Navigation
We need to reimagine how people begin their mental health journey. At the heart of this must be triage, not administrative, but clinical. A human-first system that listens, understands, and guides individuals to the right form of care from the outset.
This means:
- A move away from rigid referrals toward personalised care pathways.
- Investment in clinical triage roles to direct individuals to the right therapist, not just the next available one.
- Recognition that the therapeutic match matters, and people deserve support that’s both timely and tailored.
A Call for Systemic Change
Mental health care should never be a postcode lottery or a test of persistence. We must stop treating access as an obstacle course and start designing services that are humane, intuitive, and clinically informed.
The solution doesn’t lie in simply adding more services – it lies in building smarter, more navigable pathways to those services. We must do better for those in pain, not only to reduce suffering, but to prevent it from escalating into crisis.
Final Thought
People in psychological distress need clarity, not complexity. Support, not silence. We don’t just need more resources – we need a better route through them. Mental health systems need a human compass to guide individuals forward with dignity, direction, and hope.
About the Author
Dr Patapia Tzotzoli is a UK-trained, HCPC-registered Clinical Psychologist with over 20 years of experience in adult mental health. She is an Associate Fellow of the British Psychological Society and recognised by the European Federation of Psychologists’ Associations (EuroPsy). Dr Tzotzoli trained at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London and holds academic degrees from the Universities of East London, Oxford, and Cambridge. She is the Founder and Director of My Psychology Clinic, where she offers bespoke one-to-one online therapy, and the creator of My Triage Network, a free service connecting individuals with trusted UK-based mental health professionals.
