The BPC’s Response to the Government’s Mental Health Strategy Call for Evidence
Recently, the Government issued a call for evidence in relation to a new mental health strategy for England. This is an opportunity for policy makers to hear from individuals, communities, organisations, professionals and specialists whose experience of mental health services in the UK can inform future strategy.
The BPC responded to the call for evidence, drawing on the work and experience within our psychoanalytic professional community. We believe that meaningful integration of psychoanalytic thinking and practice in NHS services would lead to better-quality, person-centred care that tackles issues at their root.
Below, you can read a summary of our response. We highlight research and ongoing work in the mental health sphere that indicates further psychoanalytic thinking and work is required in public services. This should entail approaches framed in the long-term, that remain person-centred and prioritise the importance of the therapeutic relationship.
- Hospital to community: Effective partnership working at a community level is essential for the provision of person-centred care. These partnerships address the broad range of factors which can influence a person’s mental health recovery, such as: physical health, employment, housing, addiction, social care.
We are piloting 6 community-based mental health centres across England to understand how services can better work together at a local level to improve people’s outcomes. We would like to hear practical insights that support wider transformation of mental health care in communities. We welcome practical examples and evidence on how mental health services can work more effectively across: the wider NHS, including new neighbourhood health centres, services to support people with co-occurring mental health and neurodevelopmental conditions, different sectors, including education, employers, local authorities and the voluntary, community and social enterprise (VCSE) sector.
How can mental health services work more effectively across these areas?
The BPC’s Response
In our evidence, we highlighted studies and research that indicated how beneficial local services can be, especially when accompanied by holistic, person-centred care.
We cited the Centre for Mental Health report Improving Support for People with Complex Mental Health Difficulties (the HEARD study) which reports that piloted local services provide a better experience for service-users and their families. This person-centred approach also resulted a in dramatic fall in length of stay in, and cost of, emergency services.
We also cited Learning from the Cradle to the Grave, a study from the Royal College of Psychiatrists (2017) which reports that integrating psychotherapeutic knowledge into medicine will promote a person-centred, holistic approach for patients.
–
- Further support for patients with severe and enduring mental illness: We welcome views or evidence on what further support, in addition to NHS services, should be provided for people with severe and enduring mental illness to: help them stay well, maintain participation in education, work and community life, avoid crisis and/or hospital admission, reduce length of stay in inpatient units.
What further support should be provided for people with severe and enduring mental illness?
The BPC’s Response
Our response to this advocates for a psychoanalytic treatment that seeks to use the unconscious in therapeutic work. This requires time and intensive care and whilst integrating services into the NHS may seem costly, it will ultimately result in long-term change and savings. Evidence such as the 8-Year Follow-Up of Patients Treated for Borderline Personality Disorder study (Bateman & Fonagy, 2008) reports enduring benefits of psychoanalytic treatment still evidenced five years after treatment has ceased.
The BPC also highlighted the danger of closing down intensive services that provide containment to those with enduring mental illness like the Cassell Hospital. This is now one of the only NHS-provided in-patient units dedicated to treating severe and life threatenening non-psychotic mental disturbance.
The long-term benefits of spaces like therapeutic communities are far reaching. In a 2025 Therapeutic Communities journal article (What is the long-term impact of being part of a Therapeutic Community?), writers reporoted that four years after the closure of a therapeutic community service, staff and patients still took learnings from the service forward into their work and personal lives.
–
3. Barriers to care: What are the main barriers to continuity of care across transitions between hospital and community services, and between different levels of care, including child to adult services?
Please provide examples from either side of the transition and outline how these barriers could be effectively addressed.
In the BPC’s response, we highlighted that the person-centred approach cannot operate within a system made up of rigid barriers. We cited a discussion that took place during the PCPB’s Commission for the Future of Counselling and Psychotherapy (2026) where it was noted that “Existing government policy does not cater to the breadth and depth of mental health challenges experienced, leading to ineffective commissioning of the workforce, resources and services.” This often leads to a “one size fits all approach… [that] can be inadequate in meeting diverse client needs”.
We also noted that from a psychoanalytic perspective, the quality and continuinty of the therapautic relationship is central. Especially during particularly sensitive moments in the work. Rigid cut-offs like the ones found within the transitions between child, adolescent and adult care do not always allow for continuinty of care when it’s paramount.
A service-user in a Young Minds testimony reports feeling “discharged and stranded” after experiencing the stark difference in support between CAMHS and AMHS. A psychotherapeutic approach that where the therapeutic relationship is central would reduce stress in its service users and allow therapy its best chance of working.
–
4. Analogue to digital: It’s important that children and adults can benefit from the opportunities that digital technology can offer to boost mental health and wellbeing. However, this must be balanced with safety and protection from risks to mental health.
We understand that many people would like: more personalised, tailored mental health support available digitally, digital tools to be neuroinclusive (accessible and effective for people with neurodevelopmental conditions). A 2025 report from Mental Health UK stated that people are also increasingly turning to AI chatbots for mental health advice.
We welcome evidence and innovative examples of how digital and AI tools can be safely used for adults and children to: improve mental health and wider societal outcomes, support access to effective mental health support, complement relational care. What evidence and innovative examples are there of digital and AI tools being used to achieve these outcomes?
The BPC’s Response
Whilst we acknowledge the utility of technology and AI in some circumstances, like video-call therapy to increase accessibility, we believe the use of AI in health care is not a decision that can be taken lightly. There are factors inherent to AI technology that can put patients at risk.
As a regulator, keeping patients safe is our top priority and whilst AI cannot be traditionally regulated, it poses a safety risk that could lead to a loss of confidence in the therapeutic profession. The BPC recommend in-person therapy as the most effective format in which to recieve therapy in a safe, consistent environment that facilitates containment and reflection.
‘Artificial intelligence for mental health’ in Digital Health (2025) highlights the ‘black box’ nature of AI algorithms which makes tracking decision-making difficult. As a Regulator, it’s important to understand a therapists’ decision-making process when investigating a Fitness to Practise case. The paper also highlights ongoing issues of AI in “the accuracy and reliability of… understanding… facial expressions, speech tone, and textual content”. Non-verbal cues are essential and account for much emotional communication in the consulting room. Research from Stanford University detected “foundational and practical barriers” to AI therapy due to a lack of “human characteristics” such as “identity” which allows for connection and growth of the therapeutic relationship. AI poses threats to patient safety due to foundational issues in how it can relate to patients.
–
5. Sickness to prevention: The incidence and severity of mental health conditions has risen in recent decades, with young adults in particular now reporting substantially poorer mental health. Data from NHS England’s ‘Survey of mental health and wellbeing, England 2023 to 2024’ stated that 25.8% of young people are estimated to have a common mental health condition, up from 17.5% in 2007. Many of the solutions to mental health problems involve education, employment, housing and participation in community life. Therefore, if prevention is to be effective, we need to think beyond the realms of clinical care and across the life course.
We are especially interested in how we can identify distress earlier and support people to maintain participation in education and work. Preventative approaches include:
- primary prevention – stopping mental health problems before they start
- secondary prevention – supporting those at higher risk of experiencing mental health problems
- tertiary prevention – helping people living with mental health problems to stay well
We encourage examples of good practice within and beyond the health system, including in work and education settings where people with a co-occurring mental health and neurodevelopmental condition may particularly benefit.
Which preventative approaches have the strongest evidence for reducing incidence or severity of mental health problems and promoting good mental health?
The BPC’s Response
We began our response by highlighting the dangers of binary categorisation and terminology like ‘sickness’ and ‘prevention’. This restrictive view can have a knock-on effect in treatment and over-medicalisation of signs of distress that can often be part of development in certain stages of life. Causes and solutions to distress often lie beyond healthcare and can be to do with factors such as housing or scarcity. For example, the Office of National Statistics (2024) reports that working-age adults earning under £10k annually had 21% higher rates of depressive symptoms than those earning over £50k annually.
The creation of tiered prevetion categories creates a threshold that may mean people who do not meet the criteria, but need the treatment, may not get it. This can enforce a system that is overly reliant on diagnosis for people struggling with life due to a variety of factors. The psychoanalytic approach does not rely on diagnosis and treats the person, not the diagnosis. A wider awareness of what therapy is available inside and outside of the NHS could benefit service-users as psychoanalytic therapies are recommended to treat mental health issues such as depression – as stated in NICE guidelines for depression.
–
6. Which preventative approaches have the strongest evidence for reducing the numbers of lives lost to suicide? How can services better support the ‘missing middle’ – those with sustained needs (that affect their participation in community life, for example, in education or work) who may not meet the criteria for NHS mental health services?
The BPC’s Response
We repeated our concerns around hosting rigid criteria as a structure that often leads to people falling through the cracks of the system. This compounded with extensive waiting times exacerbates already distressing mental health struggles. A report from Rethink Mental Illness reported that four in five people waiting for support’s health deteriorated while waiting for treatment, resulting in suicide attempts, A&E visits and job loss. A restructure that prioritises person-centred care and the therapeutic relationship will prevent further deterioration through restrictive services and long wait times.
We also cited a review and meta-analysis from The British Journal of Psychiatry reporting that psychoanalytic and psychodynamic therapies are effective in reducing suicidal behaviour and self-harm, and an improvement in psychosocial wellbeing. Through addressing the root causes of distress, rather than just symptoms, psychoanalytic therapies have long-term effects that are proven to lead to a reduction in future healthcare use and sick leave.
Reassessing criteria and widening access to NHS psychoanalytic services for those in need of mental health support will provide substantial preventative offerings for those at risk of suicide.
–
Factors enabling good practice: Too often, we hear that services are hindered by administrative barriers that prevent innovative, integrated and person-centred care. We are interested in the underlying enablers of good practice around the country, and the role national government can play in creating the conditions for reformed models of mental health support. We are particularly interested to understand how access can be improved, for example through therapeutic support for certain groups such as women and girls subject to violence and/or child sexual abuse.
What commissioning, funding and oversight or accountability arrangements (nationally and locally) best support safe and integrated mental health services that improve outcomes across mental health, participation in work, education and community life, and social functioning?
BPC’s Response
We mentioned the following as examples of good practice in the sector:
- A 2022 BMC Health Services Research paper underscored the importance of thorough and intensive training of practitioners to result in tailored, effective treatment.
- A Therapeutic Communities paper (2025) that highlights the importance of the relationships between patients within a therapeutic community and how crucial the community aspect is to intensive mental health treatment.
- We highlighted the work of the Trauma Service, an award-winning provision, where trauma-informed psychotherapy treatment is accompanied by yoga, art therapy, gardening and group work to provide a holistic, cost-effective, suite of services for people with trauma-related mental health conditions.
- We also cited a research study that reported on new parents and sick infants benefitting from early therapries based on psychoanalytic thinking with the possibility of preventing future pain issues.
