The numbers are sobering: 18.5 months. That's the average wait time for NHS psychotherapy in some parts of England, according to recent data from the Royal College of Psychiatrists (December 2024).

For someone in crisis, eighteen months might as well be eighteen years.

This isn't just a statistic—it's lives on hold, relationships deteriorating, and preventable suffering extending far longer than it should.

If you or someone you love needs mental health support and you're facing impossible NHS wait times, this article outlines your options.

The Current State of NHS Mental Health Services

The Data

Recent figures paint a stark picture:

8.9 million people referred to NHS mental health services in 2023-24
1.9 million still waiting for treatment (as of November 2024)
26% of referrals wait longer than 6 weeks for initial assessment
£15.3 billion allocated to mental health (only 5.9% of overall NHS budget, despite mental health accounting for 23% of disease burden)

Regional variation is significant:

London and South East: 12-14 month average waits
Midlands and North: 16-20 month average waits
Rural areas: Even longer due to service scarcity

[EXPERT QUOTE]

"We're seeing people deteriorate significantly while waiting for treatment. What might have been manageable anxiety becomes clinical depression. Relationship difficulties become breakdowns. The system is inadvertently making people worse by making them wait." — Dr. Adrian James, President of the Royal College of Psychiatrists

Why Are Waits So Long?

Several factors converge:

Post-pandemic surge: Mental health referrals increased 39% since 2019
Workforce shortage: 13,000 unfilled mental health positions in NHS
Underfunding: Mental health receives disproportionately less funding despite growing demand
Complexity: More people presenting with severe, complex needs requiring specialist intervention

What Are Your Options?

1. NHS Services: Understanding the System

Even with long waits, NHS remains the first port of call for many. Here's how to navigate it:

IAPT (Improving Access to Psychological Therapies)

Self-referral available in most areas
Designed for mild-moderate anxiety and depression
Typically offers CBT, usually 6-12 sessions
Waits: 4-12 weeks in many areas (significantly shorter than specialist services)
How to access: Google "NHS IAPT [your area]" and self-refer

Community Mental Health Teams (CMHTs)

For more severe or complex mental health needs
Requires GP referral
Waits: 3-18 months depending on area and urgency

Crisis Services

Immediate access if you're in crisis
24/7 crisis lines, crisis cafés, street triage
Find your local service: Google "NHS crisis team [your area]"

Tips for NHS pathway:

Be honest with your GP about severity—don't downplay
Ask GP to mark referral as "urgent" if appropriate
Check in monthly on your position in the queue
Document how symptoms are affecting daily life

2. Low-Cost Counselling Options

If NHS waits are unmanageable but private therapy feels financially out of reach:

Charity and Voluntary Sector Services:

Mind: Local Mind branches often offer subsidised counselling
Relate: Relationship counselling on sliding scale (£15-75 per session)
BACP Register: Search for "low-cost counselling near me"—many therapists reserve spaces for reduced-fee clients
University training clinics: Trainee therapists offer heavily discounted sessions (£10-30) under supervision

Employee Assistance Programs (EAP):

Check if your employer offers EAP—typically provides 6-8 free confidential sessions
Often includes telephone, online, and face-to-face options
Contact HR to find out (it's confidential)

Flexible Payment Private Practice:

Many private therapists offer sliding scales based on income
It's worth asking: "Do you offer any reduced-fee spaces?"
At Kicks Therapy, I maintain a limited number of reduced-fee spots for clients experiencing financial hardship

3. Private Therapy: Is It Worth It?

Average costs: £50-100 per session (London tends toward higher end)

Advantages:

Immediate or very short wait (days to weeks, not months)
Choice of therapist and approach (not limited to CBT)
Flexible session length and frequency
Continuity (not limited to 6-12 sessions)

How to afford it:

Strategy	Potential Saving
Sliding scale/low-cost spots	£20-50 per session
Online therapy (lower therapist overheads)	£10-20 per session
Fortnightly vs weekly sessions	50% cost reduction
Health insurance (if you have it)	Often covers 10-20 sessions annually

Is it worth it?

For context: untreated mental health issues cost UK economy £117.9 billion annually through lost productivity, sickness absence, and reduced quality of life.

Investing £400-800 in 8-10 therapy sessions might prevent:

Job loss due to inability to function
Relationship breakdown
Physical health deterioration
Crisis requiring more intensive (and expensive) intervention later

One client told me: "I couldn't afford therapy, so I paid for it on a credit card. Six months later, I realised I'd spent more than that on impulse purchases trying to feel better. The therapy actually worked."

4. Digital and Online Options

NHS-Approved Apps (Free):

NHS-recommended apps: List available at nhs.uk/apps-library
SilverCloud (CBT-based online therapy)
Beating the Blues (Interactive CBT program)

Private Digital Therapy Platforms (£30-150/month):

BetterHelp / Talkspace: Messaging + video sessions with therapists
Limbic: AI-assisted CBT
ieso: NHS-contracted text-based CBT (free in some areas)

Pros: Lower cost, flexibility, no travel time Cons: Less personal, not suitable for complex issues, requires self-motivation

5. Self-Help as a Bridge

While waiting for professional support, structured self-help can provide some relief:

Evidence-Based Self-Help Books:

Overcoming series (specific books for anxiety, depression, etc.)
The Happiness Trap by Russ Harris (ACT approach)
Feeling Good by David Burns (CBT techniques)

Online resources:

NHS Every Mind Matters: Free personalised mental health plan
Reading Well scheme: Free self-help books from libraries (Books on Prescription)
Samaritans (116 123): 24/7 confidential listening service

Important caveat: Self-help works best for mild-moderate issues. Severe depression, trauma, or suicidal thoughts require professional intervention.

Making the Decision: NHS vs. Private

Consider private therapy if:

Your symptoms are significantly affecting daily life NOW
You're at risk of job loss, relationship breakdown, or worsening health
You've waited 3+ months with no NHS appointment in sight
You need an approach not offered by NHS in your area (e.g., psychodynamic therapy, EMDR, integrative approaches)
You value therapist choice and continuity

Continue waiting for NHS if:

Your symptoms are manageable in the short term
You have good support networks
Financial constraints make private therapy genuinely impossible (explore low-cost options first)
You're accessing crisis services or IAPT with reasonable waits

You can do both: Start private therapy while remaining on NHS waiting list, then transition when your NHS spot becomes available.

What's Being Done About the Crisis?

Recent government commitments (November 2024):

£150 million investment in NHS mental health workforce expansion
Faster IAPT access pledge: 75% of referrals to receive treatment within 6 weeks by 2026
Digital therapy expansion: Wider rollout of online CBT platforms

Reality check: These changes will take years to materialize. If you need help now, waiting for system reform isn't viable.

Frequently Asked Questions

Q: Will going private affect my NHS waiting list position? A: No. Accessing private therapy doesn't remove you from NHS lists unless you explicitly ask to be taken off.

Q: Can my GP prescribe medication while I wait for therapy? A: Yes. For some people, medication (typically SSRIs for anxiety/depression) provides relief while awaiting psychological therapy. Discuss with your GP.

Q: What if I genuinely cannot afford any form of paid therapy? A: Charity services, training clinics, support groups (free), crisis services, and evidence-based self-help are your main options. Contact local Mind or search "free counselling [your area]."

Q: How do I know if a private therapist is legitimate? A: Check they're registered with BACP, UKCP, or BABCP. Read reviews, have a consultation call, and trust your gut about the fit.

The Bottom Line

The NHS mental health crisis is real, and it's affecting millions. Waiting times that would have been unthinkable a decade ago are now routine.

But waiting in suffering isn't your only option.

Whether it's:

Accessing IAPT for faster NHS support
Finding low-cost charity counselling
Investing in short-term private therapy as a bridge
Using evidence-based digital tools
Cobbling together a combination of the above

...there are pathways to support, even in a broken system.

Mental health care is a necessity, not a luxury. You deserve support—don't let impossible waiting times convince you otherwise.

Access Therapy Without the Wait at Kicks Therapy

I offer:

Consultations typically within 48-72 hours of contact
Integrative humanistic counselling (Person-Centred, Gestalt, Transactional Analysis)
Flexible payment options including a limited number of reduced-fee spaces
In-person (Fulham, SW6), online (UK-wide), and walking therapy options

Free 15-minute consultation to discuss your needs and how I can support you.

Contact me today—you shouldn't have to wait months for the help you need.

If you're in crisis: Call Samaritans 116 123, text SHOUT to 85258, or contact NHS 111 (select mental health option).

Data sources: Royal College of Psychiatrists (2024), NHS England Mental Health Statistics, Centre for Mental Health (2024).

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