Becca Stacey, Senior Research Officer, Money and Mental Health Policy Institute

Mental health service wait times: a postcode lottery

24 August 2022

When we’re struggling with our mental health, being able to access timely support from mental health services can help us stay well and increase our chances of recovery. This is crucial for our wellbeing. But, it can also help protect us from the negative financial impact that often goes alongside poor mental health, such as being unable to work or difficulties managing our finances. 

Alarmingly, as our recent research reveals, the length of time people are waiting to access mental health services varies massively depending on where in the UK you live –  with people’s health and financial security at risk as a result.

Where are people waiting the longest?

Improving Access to Psychological Therapies (IAPT) is a talking therapies programme that is commonly offered to people struggling with their mental health in England. But access to this is highly dependent on where you live. In England as a whole, the average wait between an initial IAPT treatment (often an assessment appointment) and the second treatment (when people actually start receiving support) is 53 days. But this average masks significant variation, with wait times ranging from 12 days in the East Riding of Yorkshire, to 153 days in Barnsley. 

Often, the longer people have to wait to get support, the greater the toll on their mental and financial health. Among our Research Community – a group of over 4,500 people with lived experience of a mental health problem – three quarters (74%) of those surveyed said that waiting to access a mental health service had an impact on their mental health. Half (52%) said that waiting to access a mental health service had an impact on their finances. This was often related to work – in particular, the number of hours they could do, their progression and whether they could stay in employment. 

“Feel that speedier treatment would have nipped my symptoms in the bud and enabled me to keep working. Became so unwell I haven’t worked for 6 years.” – Expert by experience

The need for more data

While wait times are published for primary mental health services like IAPT, the level of detail provided in this reporting is often limited, with no information provided on the type of talking therapy treatment that is being accessed. This means that wait times for more intensive face-to-face support could be much longer than the average times reported, with shorter wait times for less intense online support potentially masking this. 

When it comes to secondary mental health services, like community-based mental health services, there is often no data on wait times at all. Last year, NHS England proposed new targets for how quickly people referred to secondary mental health crisis services and longer term secondary care support are seen. This would mean these services would have to start reporting on their wait times, but these targets are yet to be implemented. 

What needs to change

As it stands, mental health services with long wait times receive no extra resources that they can use to help reduce them. First and foremost, we want to see wait times considered as part of the funding allocation process for local health services – with funding directed to reduce the longest wait times for primary and secondary mental health services. This would help address the postcode lottery that currently exists and support the delivery of timely access to mental health support for everyone – which by default, would reduce the potential impact on people’s finances. 

Focus also needs to be given to improving how wait time statistics are reported. For primary mental health services, we want to see the relevant health bodies provide more granular data, so it’s clear how long people are waiting for different treatment types, and how long the treatment they receive lasts. This improved information will make it easier to assess whether people have equal access to different levels of support, or if more needs to be done to increase the availability of certain treatment types. 

For secondary mental health services, national health services should start by implementing wait time targets, so the relevant health bodies are required to report on how long people are waiting to access these. This would again help make it easier to assess how levels of access vary across the UK, exposing any inequalities and areas where increased funding is required. 

No-one’s mental and financial health should be placed at greater risk because of where they live. More detail on the steps local and national decision-makers can take to reduce this postcode lottery, and ensure everyone has timely access to services that support our mental and financial health, are outlined in our report, No one left behind