by Daisy Harmer, Research and Policy Analyst at PBE

With one in five children, aged eight to 16, estimated to have a probable mental health condition last year, the need for action could not be starker. Recognising the nation’s mounting mental health problem, the government has pledged to provide support to those most at risk through the NHS Long Term Plan and a new suicide prevention strategy. Ahead of a general election due at some point this year, the Labour Party has also recognised the need to address mental health and suicide as part of its five missions for a better Britain. All three of these policy pieces emphasise the importance of working with charities and communities to turn the tide on unmet mental health needs, but it is clear more is required from policymakers and commissioners to enable the charity sector to meet the ever-growing demand for its expertise.

The size of the challenge is considerable, with more people than ever before in contact with NHS mental health services. In August last year, 1.8 million adults engaged with NHS mental health services – more than the populations of Manchester and Birmingham combined. Mental health problems have similarly grown among children and young people, both in prevalence and severity. Last August, more than 70,000 referrals for children and young people were made to secondary mental health services in England, more than twice the number made in August 2016.

This growing demand is not being met by a sufficient supply of services. Nearly a quarter of adult mental health patients waited more than 12 weeks to start treatment in 2022 and almost half of these patients said prolonged waits for treatment caused their mental health to worsen. In these circumstances, the role charities can play is critical, from prevention through to crisis point.

As mental illness increases and services struggle to keep up with demand, the risk of mental ill health becoming entrenched also grows, with people becoming sicker and treatment potentially less effective. These growing, unmet mental health needs mean more working-age people than ever before are reporting mental ill health impacting their wellbeing and ability to work.

In response to these escalating issues, the government recently committed to increasing the numbers benefitting from NHS Talking Therapies by 384,000 over the next five years and boosting the number of sessions available. The Back to Work Plan also aims to support 100,000 people with severe mental illness to find and keep jobs over the next five years via its Individual Placement and Support programme. Charities will be key to providing the support and services outlined in both schemes. The increase in talking therapies is a small win and many adults will hopefully benefit from the additional support. However, concerns have been raised about the strengthening of the benefits sanctions system under the government’s new plans and its potential impact on people who are already vulnerable.

A recent review of NHS Talking Therapies identified concerns about the barriers that people of colour face in accessing NHS mental health services and support. The review noted that poor outcomes from talking therapies were reduced and even disappeared when access was improved and culturally sensitive therapy was provided, citing areas of good practice from charity organisations and community partners.

Charities, driven by purpose, social impact and community welfare, excel in supporting people with mental health needs in many of the areas that policymakers have highlighted as priorities. Prevention and early intervention are pillars of the government’s suicide prevention strategy, the NHS Long Term Plan and Labour’s mission - with a strong emphasis on delivery by community groups and charities. Understanding what matters to individuals and their communities is crucial for service providers, enabling them to respond effectively and meaningfully.

With an estimated 1.5 million people accessing its support, the charity sector is the largest provider of NHS-commissioned mental health services. In the UK, there are close to 3,100 charities providing counselling and therapy. These organisations are a powerful part of the health and wellbeing landscape and are likely to play an increasingly central role in mental health services. Indeed, several Integrated Care Systems (ICSs) and local authorities are already seeing the benefits of partnering with small charities to deliver targeted, localised solutions to support mental health. For example, after a rise in suicides in Liverpool, the city’s public health team invested £500,000 in small community groups to support mental wellbeing and are trialling a community-based mental health strategy with 40 voluntary and community organisations, which has so far benefited over 2,000 people - 98% of whom would recommend the services.

Charities also provide mental health support at scale. In total, there are 3,400 charities in the UK working to support the nation’s mental health, from raising awareness through impactful campaigns and advocacy efforts, to challenging stigma and promoting open dialogue about mental health. In 2022/23, mental health information and advice provided by Mind online was accessed 23.3mn times, while staff working for the Campaign Against Living Miserably (CALM) answered over 155,000 calls and web chats and spent more than 1mn minutes on their helpline in 2021/22. 

Nevertheless, the charity sector faces real challenges in meeting the demands that are now placed upon it. Many of the fundamental building blocks integral to effective collaborative relationships are missing between charities and health and care commissioners. Both commissioners and charities encounter inflexible and disparate information systems, with a lack of investment in coordination, networking, and capacity-building. Imbalances of power also exist among voluntary and community organisations, with some organisations struggling to get their voices heard.

While addressing the challenges that exist within the relationships between charities and public bodies is vital, there is also an urgent need to support the capacity of the ecosystem of charities in the UK. Policymakers should recognise that successfully reversing the nation’s mental health crisis relies on a charity sector better able to fulfil its full potential. With 3,400 charities nationally dedicated to mental health and 1.5mn people receiving NHS-commissioned mental health support from charitable organisations each year, this investment in the sector is crucial.

As outlined through the work of the two-year Law Family Commission on Civil Society, conducted by Pro Bono Economics, strategic investment in the charity sector is key to national recovery and growth on multiple fronts, not least in addressing the UK’s mental health crisis. This requires funders and government to support the sector in boosting its productivity – through greater investment in the likes of skills training and digital capabilities – and improving the data available to and about the sector, as well as helping to unlock greater giving.

Unleashing the full potential of the sector would mean enabling the thousands of mental health charities up and down the country to have the greatest possible impact with the resources available. Progress towards this goal would be a giant leap in the right direction for the nation’s mental health.