Waiting for a diagnosis shouldn’t mean waiting for mental health support.

We support Professor Peter Fonagy’s call, in his independent review published today, for a more flexible, needs-led approach, where people can get help based on what they’re experiencing rather than having to wait for a diagnosis.

This would be a fundamental and essential change in the Government's approach to mental health support.

The Government has already responded to the review, with a commitment to earlier support, earlier access to help and a stronger focus on prevention and early intervention. 

Rising mental health needs highlight the importance of early support

The review highlights growing mental health needs, particularly among children and young people, and the pressure this is placing on existing services. It calls for earlier intervention and better coordination between services, helping people access appropriate support before their difficulties escalate.

Dr Lisa Morrison, BACP Chief Regulation and Standards Officer, said:

“For counselling and psychotherapy, this may be one of the most significant policy reviews of the decade. It’s put people’s needs, rather than diagnosis, at the heart of the conversation. A diagnosis can be valuable, but it must not be the primary gateway to getting timely access to mental health support.

“People shouldn’t have to wait months or even years for an assessment before they can get help. Early access to psychological support can make a real difference, helping people get support while they’re struggling rather than waiting until their difficulties become more severe.

“Counselling and psychotherapy can provide that support without someone needing to have a diagnosis first. It's essential that we create the pathways and opportunities needed to expand the mental health workforce, so people can get the support they need sooner. We have a skilled workforce with additional capacity to help – if only the opportunities within the NHS existed.”

Mental health support without a diagnosis

Professor Fonagy’s review also makes the case for support based on people’s needs, rather than whether they meet the criteria for a particular diagnosis.

It recognises that diagnosis remains important, particularly where it helps people understand their experiences or access specific support. But it also highlights the importance of looking at someone’s functioning and quality of life, rather than relying on diagnosis alone.

This is particularly important when people are facing long waits for assessment. In our member survey, nearly all therapists (97%) said long waits for diagnosis is a barrier for their clients, while three quarters (75%) cited the cost of private assessment.

Why earlier mental health support matters

Counselling and psychotherapy can give people access to psychological support while they wait for assessment or where a diagnosis isn’t the starting point for their care.

We’ve previously highlighted that trained counsellors and psychotherapists could provide around 100,000 hours of extra therapeutic time a week to the NHS.

Much of the counselling and psychotherapy already being provided takes place outside the NHS and isn’t captured in official service data. This means the contribution of the existing workforce may not be fully reflected in planning for mental health services.

The role of counselling and psychotherapy

Lisa continued:

“This is an opportunity to make better use of the counselling and psychotherapy workforce and give people more choice about the support they receive.

“There are skilled professionals ready to do more, and we need to make sure their expertise is utilised as part of the response to growing demand for mental health support.

“The forthcoming Mental Health Strategy is the Government’s opportunity to act on the findings of this groundbreaking report, address the mental health crisis and deliver services that truly meet people’s needs. It is important that BACP is part of key conversations with the Minister, Alison McGovern MP, to enable more counsellors and psychotherapists to support the nations mental health.”