Why therapy waiting lists are broken

How to speed up your NHS mental health referral

You can be seen sooner by self-referring to NHS Talking Therapies without waiting for a GP, using your Right to Choose to pick a provider with a shorter waiting list, and asking to join a cancellation list. None of these jump a queue unfairly. They use rights and routes many people simply don't know they have.

1. Self-refer instead of waiting for a GP referral

For anxiety and depression, you can refer yourself directly to NHS Talking Therapies in England, with no GP appointment needed. You just need to be registered with a GP and be 18 or over (16+ in some areas). This skips the wait for a GP slot entirely. Find your local service on the NHS website.

2. Use your Right to Choose

In most cases you have a legal right to choose which mental health provider you're referred to in England, including providers outside your local area, and ones with shorter waiting lists. Your referrer should offer up to five options. If a neighbouring provider can see you sooner, you're entitled to pick them.

3. Compare waiting times before you choose

Waiting times vary enormously between providers. You can check and compare them on the NHS website and on My Planned Care, which is updated weekly. A provider a little further away may see you months sooner.

4. Know the standard, and chase it

NHS Talking Therapies has a national target: 75% of people should get a first appointment within 6 weeks of referral, and 95% within 18 weeks. If you're past that, it's reasonable to contact the service to ask where you are in the queue and whether earlier slots exist.

5. Ask to be added to a cancellation list, and stay flexible

Letting a service know you can take a short-notice or off-peak appointment can move you up considerably.

6. Get something in place for the meantime

Getting on the NHS list is still worth doing. The support, when it comes, is good. But waiting unsupported isn't neutral. Regular physical activity has a well-evidenced effect on anxiety, and a small number of focused sessions with a registered therapist can help you hold steady. brightloaf offers on-demand sessions with professionally registered therapists from £14.99, currently available in the UK, built for exactly this gap. (See how anxiety apps that connect you to a real therapist compare.)

Why the waiting lists are broken: a GP's view

I want to start by saying something that might seem counterintuitive coming from someone who built a private therapy platform: the NHS is not the villain here.

The people working in NHS mental health services are, in my experience, dedicated and skilled. The problem is systemic. Demand for mental health support has grown far faster than the capacity to provide it, and the gap between the two has been widening for years.

But the consequences of that gap fall on people who are already struggling. And that is something I cannot just observe neutrally from my consulting room.

The numbers

According to BMA analysis of NHS data, an estimated 1.7 million people in England are waiting for mental health care as of 2025. Within that, over 16,500 people have been waiting for mental health treatment for more than 18 months, according to NHS data analysed by Rethink Mental Illness. In some areas, individual patients have waited over two years for a first talking therapy appointment. The picture varies significantly by region and by service type.

Research from organisations including Rethink Mental Illness has documented that people's mental health deteriorates while they wait. That is not a surprising finding. Anxiety left untreated tends to become more entrenched. Avoidance behaviours become more established. What could have been addressed in a handful of sessions becomes more complex and harder to shift.

What happens to people while they wait

As a GP, I have seen this pattern many times. A patient comes in, I refer them to NHS Talking Therapies, and I do my best to support them in the meantime. Repeat prescriptions. Safety netting. The occasional longer appointment when something flares up. It is not nothing. But it is not therapy.

Some people find their own ways through the waiting period. Exercise, self-help books, talking to friends. Some of those strategies are genuinely helpful. Others cope by avoiding, withdrawing, or numbing. And a proportion deteriorate to the point where they need more intensive support by the time they are eventually seen.

None of this is inevitable. It is the consequence of a system that is under-resourced for the demand it faces.

Why waiting is not just inconvenient

There is a tendency to frame mental health waiting times as an inconvenience rather than a harm. I want to push back on that framing. Waiting for a broken leg to be treated would not be described as inconvenient. We would call it what it is: a delay in necessary medical care.

The same logic applies to mental health. Anxiety disorders are real conditions with real consequences. They affect employment, relationships, physical health, and quality of life. Waiting months or years for anxiety therapy is not a neutral event.

What you can do while you wait

If you are on an NHS waiting list for talking therapy, or if you are trying to get onto one, there are things that can help in the meantime. Getting on the list is still worth doing. NHS therapy, when it arrives, is good. Self-referring to NHS Talking Therapies in England is possible without a GP referral.

Physical activity has a well-evidenced effect on anxiety. Even moderate regular exercise makes a meaningful difference for many people.

And if you can access even a small number of focused sessions with a qualified therapist in the meantime, that is worth considering. brightloaf offers on-demand sessions with professionally registered therapists from £14.99, currently available in the UK. It is not a permanent solution for everyone, but for the people I built it for, namely those who are waiting and need something to help them get through, it is a real option.

The case for change

I do not think the answer to the mental health waiting list crisis is to privatise NHS provision. The answer is to properly fund mental health services. But while we wait for that, people are still struggling today.

Building something that could help people access professional support faster, more affordably, and without unnecessary barriers felt like the most useful thing I could do with what I know. That is why brightloaf exists.