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Neurological Health Q1 2023

We can’t talk our way out of the chronic mental health workforce shortage

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Dr Adrian James

President, Royal College of Psychiatrists

Almost two-thirds of people needing mental health support were not in contact with NHS services in 2021, according to a recent report from the National Audit Office.


An estimated 8 million people did not access the mental health support they needed, highlighting a significant treatment gap in England. We also know at least 1.4 million people are currently waiting to receive care from NHS mental health services.

At first glance, these statistics may give the impression that services are falling short. However, the number of people in contact with NHS mental health services grew at an alarming rate from 3.6 million to 4.5 million in the space of five years.

The problem is that demand for mental health services is rising at an unprecedented rate, and faster than investments are being made into expanding the workforce. This sits alongside other barriers to people accessing support, such as stigma and long waiting times.

Cost of living and mental health crises

The need for a properly funded mental health workforce has never been greater, as millions of people across the country endure the cost-of-living crisis. The Office for National Statistics (ONS) has found that food prices remain at record highs while the cost of electricity and gas continues to rise. It is only natural that people who are struggling to eat or stay warm may also experience difficulties with a mental illness, such as anxiety or depression.

The need for a properly funded mental health
workforce has never been greater,
as millions of people across the
country endure the cost-of-living crisis.

The cost-of-living crisis is also a mental health crisis. Around one in four adults who struggled to afford their rent or mortgage payments had moderate to severe depressive symptoms, according to the ONS. We also know mental illnesses disproportionately affect disabled adults, people living in deprived areas and other vulnerable groups.

Protecting patients and practitioners

The Government needs to honour its commitment to publishing a ‘comprehensive’ NHS Workforce Plan this year. This should provide ways to improve retention and recruitment so that we can alleviate the pressure impacting patients and practitioners.

We are calling for NHS trusts to be supported to meet an annual 4% improvement target in retention of mental health staff and increase medical school places to 15,000 by 2028/29.

The College’s latest analysis found that at least £500 million of the NHS Long Term Plan’s original settlement for services, could be lost due to inflationary pressures. The Government needs to address this gap in mental health funding if it is to ensure its commitment of £2.3 billion in real terms by 2023/24. A larger and better-trained mental health workforce will save more lives, ensure everyone has access to care and reduce waiting times.

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