How much demand is there on mental health services?
We're all talking more about mental health and taking action to look after our mental wellbeing. At the same time, we're facing more stress and pressure in our daily lives. This guide looks at the increasing demand for mental health services and how health insurance can help.
Are we facing a mental health crisis?
The past few years have brought greater uncertainty and instability, which has impacted people's mental health. The pandemic disrupted our lives and education for our young people, and the cost of living crisis continues to cause stress, which increased demand for mental health services.
In 2014, the Government survey of Mental Health and Wellbeing in England found that 1 in 6 people over 16 had experienced mental health issues. A further study is currently in progress. However, a more recent survey by the Mental Health Foundation showed that the cost of living crisis is causing greater feelings of stress, anxiety and depression. People with mental health issues benefit from good-quality sleep, regular exercise and time with friends, but financial issues and mental health problems have reduced their ability to engage in these activities.
Mental health conditions can affect people's lives in various ways depending on the type of mental illness they experience and its severity. Everyone can experience issues which require mental health support from time to time. Sadness, grief, stress and worry are a normal part of life. Taking action to meet our mental health needs, for example, by seeking support from friends or family, can help us process our feelings without needing treatment from mental health services.
Without mental health support, mental illness can affect our ability to work, sleep, take care of ourselves and engage with our friends. We might also resort to other coping strategies, such as increased alcohol use, which only worsens the problem. Physical health issues and mental health conditions often go together. For example, anxiety and depression can lead to insomnia, lack of appetite and an inability to concentrate. These can make it challenging to work and engage with treatment from mental health services. In extreme cases, mental illness can lead to unemployment and even homelessness. It can also cause increased social isolation, resulting in a vicious circle of worsening mental health.
It's estimated that 12.7% of all sickness absence in the UK is due to mental health problems. That can clearly cause issues for employees who are unable to work long-term. However, workforce shortages also impact businesses that may lose skilled workers due to poor mental health. It makes sense for employers to support their employees' mental health needs to improve productivity and employee retention. Such support will typically come from secondary mental health services, for example, private counselling, which is available as part of an employee assistance programme.
However, even with appropriate support from mental health services, mental illness can become more severe. Mental ill health is now the most significant cause of disability in the UK, outstripping even cancer and heart disease. It's estimated that mental ill health costs the UK economy £105.2 billion every year. That comprises the cost of NHS mental health services, social care, and informal care, for example, where a family member cares for an individual and claims carers' benefits where they would otherwise be in paid employment. It also factors in the costs of lost productivity and employee spending. For example, suppose an individual's mental health difficulties cause them to withdraw from social activities. In that case, this can mean lost revenue for restaurants, pubs, fitness clubs and businesses offering other social activities.
As more people experience mental health challenges, it's no surprise that there's also increased demand for mental health services. The number of patients referred to and receiving treatment from NHS mental health services increased by 16.2% between 2020-21 and 2021-22. It's unclear how much of this increase resulted from the COVID-19 pandemic.
Quick access to mental health services can help prevent mental health problems from worsening. However, research by the Royal College of Psychiatrists (RCP) found that 23% of patients experienced waiting times of over 12 weeks, with 43% of those experiencing worsening symptoms as a result. Approximately 12% of patients wait more than six months, while 6% wait more than a year. The figures on NHS waiting times for mental health services include access to talking therapy services, eating disorder services for young people and early intervention in psychosis. There are plans to include specific mental health waiting time data for other NHS services in the future.
The RCP puts increased waiting times down to a need for qualified psychiatrists. There is currently only one psychiatrist for every 12,567 people in England.
Counselling and other talking therapies can help with various mental health conditions, including anxiety, depression, OCD, PTSD and eating disorders. Research has shown that counselling is as effective as medication in resolving mental health conditions. NHS mental health services aim to increase access to talking therapy services. However, provision depends on the approach taken by individual community mental health services. Some services don't offer counselling to patients at risk of suicide, who self-harm or who have a history of childhood abuse. The Wirral Complex Needs service was created to support patients with mental health needs that often prevented them from engaging in formal treatment and uses talking therapy along with practical support. A typical patient may have a learning disability and another mental health condition that standard treatment pathways struggle to address. They've found that their patients often end up in crisis and seek emergency care, often from their GP. However, there's been a reduction in the number of emergency appointments and admissions to inpatient mental health beds since the service was set up.
Vitality's Health Claims Insights Report 2023, which looks at private health insurance trends among Vitality's customers, bears this out. While claims for talking therapies have increased in the last eight years, claims for inpatient psychiatric care have dropped. Of their customers who received counselling, only 1% needed further treatment. This has also cut costs; Vitality's overall spending on mental health services has been reduced by 32% since 2019.
NHS mental health services are available free of charge and take various forms depending on your needs. There are adult mental health services and separate mental health services for children and young people as part of Child and Adolescent Mental Health Services (CAMHS).
Mental health services offer different types of care, including community mental health services and inpatient treatment. As we've mentioned, counselling and talking therapies can be highly effective. However, doctors may also use medication or other forms of treatment as necessary.
There's been increased demand for NHS mental health services, so NHS guidance also includes information on private counselling and support from charities. Some charities, such as the Samaritans and Childline, offer one-off support for adults, children and young people in crisis and are unlikely to offer a long-term solution. However, other specialist services can provide a course of therapy. Some examples include:
- Relate - for relationship advice and couples counselling
- Cruse - for bereavement support via individual or group counselling
- Rape Crisis - specialist counselling after rape, sexual assault or abuse
Here are some mental health services you can expect to find when accessing care via the NHS.
1. GP mental health services
Your GP is the first stop when you need to access NHS mental health services. Before referring you, they'll assess you to decide what treatment will best meet your needs. Young people can also seek support from their school.
A GP can refer you to other mental health services, such as a therapist or other specialist mental health services, depending on your needs. For example, you may need dedicated support from eating disorder services or group therapy for addiction. There are also specialist young people's services. In some circumstances, they can signpost your partner or family members to appropriate support services if needed.
However, they may also be able to provide treatment at your GP surgery. Some practices work with psychologists, community psychiatric nurses and occupational therapists to provide treatment within the practice. The Government plans to expand services by funding mental health teams within GP surgeries and allowing patients to book appointments directly. The idea is that specially trained staff can assess and treat or refer patients without a GP appointment.
2. Talking therapy services
We've mentioned how counselling and talking therapies can positively impact mental health. They're available from NHS mental health services in various forms, including one-to-one support in person, via telephone or video. You can also choose to take a self-guided online course. Some services offer group therapy too.
Your GP can refer you, but you can also self-refer. Talking therapies can help with anxiety, depression, stress, PTSD and panic attacks, among other things. Counselling also helps with phobias, obsessive thoughts and insomnia. You can refer yourself online, and a mental health professional will contact you to carry out an assessment and refer you for suitable treatment. This process can take a few weeks, so self-help resources are available while you wait. There's a different system in place for children and young people. They can't use the same self-referral system and should access care via CAMHS instead.
There are different types of therapy so you can receive treatment that meets your needs. You may be offered guided self-help, counselling, cognitive behavioural therapy or couples therapy. You can choose how you receive treatment; you may be happy to speak to a counsellor online or prefer face-to-face therapy, and your local services should offer you the choice.
3. Out-patient care
If you need more support than counselling can provide, you can access other types of mental health support. Community mental health services create teams of professionals who can tailor your care to suit your needs. Teams typically include a community psychiatric nurse, a counsellor and a psychologist. There's also support to help you with your day-to-day activities, for example, if you struggle to care for yourself or your home. Your care team will also likely have an occupational therapist, community support worker and social worker. One person will typically oversee your care and will be your main point of contact.
Your community mental health team can also support your family and carers.
In some circumstances, social services can help with practical tasks. Mental health conditions can make it difficult for you to manage your finances or put a strain on your relationships, and social services can provide support and guidance. Mental health treatment only succeeds if you engage with it, and social care can help you put systems in place to ensure you attend appointments. This could be as simple as helping you book transport.
If you can't work, you may be entitled to benefits. If a family member cares for you, they could also claim financial support; social care can guide you through the benefits system. The charity Mind offers guidance to help you understand what you may be entitled to.
4. Hospital treatment
Sometimes, a mental health disorder becomes more severe and needs inpatient care in a hospital. Hospital treatment can be required for many reasons; you may be in crisis or need monitoring to help doctors decide how to care for you long-term.
You'll typically receive treatment in a specialist mental health unit, which can help keep you safe if you're at risk of hurting yourself or someone else. Specialists staff units, so you can see a psychiatrist, psychologist or mental health nurse as needed.
If your doctors feel that you're at risk of harm, they can apply to section you under the Mental Health Act 1983. The police can also take you to a mental health unit if you're under arrest or if they find you in a public place and believe you may have a mental health disorder. You might be sectioned so that mental health professionals can assess you or provide treatment.
Alternatively, you might feel that you need hospital treatment to benefit from 24/7 access to care. You can ask for a voluntary admission if you want to.
5. Residential care
Short-term residential care differs from hospital treatment, allowing you to access group therapy and practical support to live independently. Some residential communities provide counselling and other therapies as part of your treatment and can include one-to-one treatment or group therapy as needed. They can be helpful for people who have received inpatient care but need extra support as they recover. Hostels can also provide short-term accommodation for people who need a halfway house to help them learn to live independently.
Long-term residential care is also available and comes in two main forms depending on a patient's needs. Supported housing for people with mental health conditions is similar to supported housing for older people. The people who live there can live independently but sometimes need access to support. This can include practical support from care workers or mental health care from in-house therapists.
By contrast, care homes provide accommodation for people with severe mental health disorders who can't live independently and need a high level of support with every aspect of their mental health and daily lives.
6. Crisis intervention
As mentioned, people experiencing a mental health crisis can be sectioned and receive inpatient treatment in a mental health unit. You may need this if you'll likely harm yourself or other people.
However, there are also crisis resolution and home treatment teams. As the name suggests, they can provide treatment and support if you experience a crisis while enabling you to stay at home. This approach can be beneficial as it lets you access your usual support network and receive extra support while remaining in your home. If you're already feeling anxious or stressed, going to an unfamiliar place could make things worse.
If you already see a mental health professional, they may give you a phone number for the crisis team so you can call them immediately rather than needing to call 999.
How can we look after our mental health?
Taking care of our mental health involves many of the same things as looking after our physical health.
Exercise is great for our physical wellbeing, but it also releases endorphins. These can make us feel happier, reduce stress, improve our concentration, and act as a natural painkiller. Any type of movement can help, although choosing something you enjoy is a good idea. Exercising outside and spending time in nature has additional mental health benefits, such as making us feel calmer.
Eating well can support your mental health by feeding your brain with the nutrients it needs to stay healthy. Mind offers guidance on helping your mental wellbeing through diet, including eating plenty of fruits and vegetables, getting enough protein and fat, and safe alcohol use. Eating meals with friends and family strengthens our social links, which can help reduce loneliness and feelings of isolation.
A strong support network can help us talk about problems before they escalate. It's important to acknowledge things that you find stressful and create strategies to manage those feelings. Daily life can involve many stressors, whether at work, at home, or even watching the news. You can find online support to develop self-help strategies or see your GP for medical help.
Private health insurance can provide access to healthcare for mental and physical health issues. You can select a provider and policy that meets your needs and budget, and you're covered as soon as you start paying premiums.
Every health insurance policy provides a basic level of coverage, and you can tailor your policy by adding optional extras. Most policies include some mental health support, usually up to eight counselling or CBT sessions, which you can access without needing a GP referral. If you want more mental health coverage, you'll typically need to pay more to add it to your policy.
However, it's worth shopping around and getting advice from a specialist health insurance broker, as some providers offer more mental health services than others as part of their core policy. Bupa prides itself on providing coverage for more mental health conditions than any other health insurer. It also offers a family mental health telephone service where you can seek advice about children and young people's mental health, even if they don't have their own health insurance coverage.
Health insurance exclusions
Every health insurance policy has exclusions, meaning it won't pay for certain types of treatment. Some are standard exclusions, while others depend on your medical history. Health insurance doesn't cover chronic conditions that need long-term management and typically excludes coverage for straightforward pregnancy and birth, cosmetic surgery and treatment for addiction. However, there are exceptions. Bupa's health coverage does include care for alcohol or drug addiction.
Health insurance also excludes pre-existing conditions. If you saw your doctor about a mental health disorder during the five years before buying the policy, it'll be excluded for the first two years. Again, there are exceptions. With Vitality, you can still access counselling even if you had a psychiatric condition in the past.
So, what support can your health insurance offer?
Access to counselling and helplines
As we've mentioned, health insurance offers access to counselling, often on a self-referral basis. This is typically limited to up to eight sessions per year. However, you can increase the number of available sessions by paying an additional premium for extended coverage. Counselling can benefit most psychiatric conditions and may mean that you don't need further treatment. In addition, if you opt for Mental Health cover with your health insurance, you'll be able to access a broader range of mental health professionals and even inpatient treatment if required,
In addition, most health insurers provide online resources and helplines to help you manage your symptoms or seek informal support when needed. Some helplines can help you access guidance on financial or legal issues that can cause stress.
Inpatient and outpatient treatment
Health insurance can cover inpatient and outpatient treatment if you have the right coverage. You can access the same types of treatment and therapy that you would with the NHS. However, you'll likely face shorter waiting times.
If you need inpatient care, you can be treated in a private hospital and have your own room. This can give you a more relaxing environment to help you rest and recover. You may also benefit from hotel-style facilities such as a private bathroom and restaurant-quality food.
Getting professional advice
MyTribe guides are designed to help you understand your healthcare options and make informed choices about your medical treatment. Our guides shouldn't be regarded as tailored financial advice.
If you'd like to know more about private health insurance and find the right coverage for your needs, contact us for a comparison quote. We'll put you in touch with a specialist, regulated broker for individual advice tailored to your circumstances.
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Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.