England is grappling with a “silent mental health pandemic,” according to Dr Lade Smith, president of the Royal College of Psychiatrists. She warned that mental health services are often overlooked and underfunded because mental illness is invisible to many, leading to stigma and less public urgency compared to physical health crises.
Dr Smith explained that funding tends to prioritize visible problems, such as overcrowded hospital corridors, because “the cog that squeaks gets the oil.” This approach neglects the growing number of people suffering from mental health issues. Currently, over four million people are in contact with mental health services in England—a substantial increase from 2.6 million in 2016/17. Among those, 1.8 million have been referred but are still waiting for treatment.
The rise in mental health cases has been particularly noticeable among children and young people, with 1.2 million youths accessing mental health services in 2024/25, up from 500,000 a decade earlier. Dr Smith expressed concern that less than a third of those needing care actually receive it. “These are illnesses that profoundly affect people’s lives. Imagine if this were leukaemia,” she said.
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Dr Smith highlighted that anxiety and depression have surged, largely due to increased social risk factors such as poverty, financial insecurity, debt, and trauma. She emphasized that 70 to 80 percent of mental illness is driven by these social determinants rather than strictly clinical causes, pointing to the need for broader societal interventions to reduce risk.
The doctor also criticized the ongoing structural discrimination faced by those with mental health conditions. Stigma persists in popular attitudes, with misconceptions like “just pull yourself together,” which create barriers for both patients seeking help and professionals advocating for better resources.
“The issue is that mental health problems aren’t as visible, and so they don’t get the same voice at the decision-making table,” Dr Smith lamented. This invisibility results in less funding despite the widespread impact—mental health issues account for 20 percent of England’s overall disease burden but receive under 9 percent of NHS funding.
Dr Smith stressed the urgent need to increase investment in community mental health care, expand inpatient bed capacity, establish clear patient outcome and wait time standards, and boost research funding. She warned, “There is no greater threat to the health of children and young adults than this silent mental health pandemic that is spiralling out of control,” noting the tragic consequences of untreated illness, including school and work absences, self-harm, and suicide.
In response, a Department of Health and Social Care spokesperson affirmed the government’s commitment: “It is vital that anyone struggling with their mental health is able to access the timely help and support they need. We’re investing an extra £688 million in mental health services this year, hiring almost 8,000 additional mental health workers, and expanding Mental Health Support Teams across all schools and colleges in England. New 24/7 Neighbourhood Mental Health Centres and Mental Health Emergency Departments are also being introduced to ensure help is always available.”