Understanding the scale of the challenge
With demand for mental health care growing and patient needs changing, the NHS has worked hard to respond, increasing access and transforming models of care within the resources available. However, there is still significant unmet need. Mental health services are also facing considerable pressure and challenges to consistently delivering high-quality, safe care.
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During 2023/24, there were over 30 million contacts delivered by services – this is up 14.4% compared to before the pandemic. Detentions under the Mental Health Act increased by over 1,500 over the same period.
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As of March 2025, 385,540 children and young people were still waiting for treatment from community mental health services, up 14.4% compared to last year.
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In NHS Providers' autumn 2024 survey of trust leaders, more than 9 out of 10 respondents from mental health trusts said they were worried about their trust’s capacity to meet demand over the next 12 months. A 'financial reset' for the NHS has since been announced: almost half of trust leaders (47%) have told us that they would have to scale back services in the coming year to deliver their financial plans within this new context, and a further 43% said this was under consideration.
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Only 41% of people with a learning disability and / or autistic people who are in hospital could have their needs met in the community with appropriate support, and more than half of those in hospital have been there for two years or more.
NHS trusts from across the acute, community and ambulance sectors have joined mental health leaders to raise serious concerns about whether current levels of overall funding for mental health services are enough. They have questioned whether mental health care is being appropriately prioritised locally and nationally, and particularly those services for individuals with severe and enduring mental illness.
Our April 2025 briefing, Mental health: shifting the focus, set out in more detail the key challenges currently facing the mental health sector and how trusts are responding and innovating. We also highlighted the need for more coherence on what needs to be prioritised in the short to medium term to deliver high quality, sustainable mental health services in line with the “three shifts” in care the government wants to see over the next decade. Those three shifts see care moving from hospitals to the community, from treatment to prevention, and from analogue to digital.
This briefing – our call to action
NHS Providers has been working to explore with trust leaders and wider stakeholders where consensus lies in what needs to be prioritised, and how to deliver what’s needed in practice. Our discussions have revealed numerous areas of agreement and opportunities for government and the sector.
The discussions have also re-confirmed the breadth and depth of good practice being delivered by NHS mental health trusts and their partners across the country. This offers valuable insights and lessons for providers, commissioners and policymakers to improve in line with the three shifts.
This briefing shares our findings and recommendations ahead of the comprehensive spending review concluding and the implementation of the 10-year health plan. Both provide a critical opportunity to secure the funding and focus the mental health sector requires to build on the work undertaken in recent years to deliver sustainable, high-quality mental health services. This is essential for individuals, their families, and the wider system, society and economy over the next decade.
We set out in this briefing our analysis and the key actions that the mental health sector, government and national bodies should collectively prioritise in order to deliver values-driven, patient-centred, and staff-enabled mental health care. We also include case studies to illustrate the opportunities at hand. This will support the delivery of the three shifts, and better meet the mental health needs of individuals, society and the economy over the next decade.