Investment priorities for mental health 2025
Executive summary
At a time of rising demand for mental health care and years of declining mental wellbeing in society, mental health services in England are under enormous pressure. The upcoming ten-year health plan and Spending Review present the government with the chance to deliver on its manifesto commitment to address the disparities between mental and physical health in the NHS and elsewhere.
This is an opportunity for the government to ensure public money is spent wisely, on services that will meet people’s needs effectively, equitably and in a timely manner, while boosting economic activity, increasing living standards and improving health, in support of its core missions.
Commissioned by the NHS Confederation’s Mental Health Network as part of the Mental Health
Economics Collaborative (MHEC), this report draws on existing evidence about six investment
priorities that would support better mental health and represent good value for money.
The six priorities are:
Enabling health visitors to support new mothers' mental health
Context: Around one in four women (25.8 per cent) experience a perinatal mental health problem (Office for Health Improvement and Disparities, 2025), up to 70 per cent will hide or underplay maternal mental health difficulties, and suicide continues to be a leading cause of maternal death in the first year after childbirth (Maternal Mental Health Alliance, n.d.).
Untreated perinatal mental health problems have long-term health and social costs amounting to roughly £8.1 billion per cohort of births (Bauer et al., 2014).
Recommendation: Provide sufficient funding and resources to enable professionals in regular contact with pregnant women and new mothers (such as midwives and health visitors) to assess and provide early mental health interventions for those identified as in need of additional support. Adopting this type of approach to service provision is estimated to produce a net saving of £490m over ten years (Bauer et al., 2022).
Providing evidence-based parenting programmes
Context: Conduct disorders affect as many as one in 20 5-19 year olds (4.6 per cent) in England (NHS Digital, 2017) and are associated with a range of negative life outcomes, including lower educational attainment, poorer mental health and increased involvement in criminal activity (Colman et al., 2009; Olino et al., 2011).
Recommendation: Build universal access to evidence-based parenting programmes, such as Triple P and Incredible Years (IY). The IY parenting programme has been reported as an effective intervention that benefits all families, including disadvantaged families and those from racialised communities (Gardner et al., 2017). Such programmes produce potential savings ranging from £1,000 to £8,400 per child over a 20-year period (ibid).
Expanding the network of early support hubs for young people
Context: Around 50 per cent of mental health problems are established by the time a child reaches the age of 14, and 75 per cent by the age of 24. Early support hubs offer easy-to-access drop-in support on a self-referral basis for young people who may not meet the threshold for children and young people’s mental health services (Children and Young People’s Mental Health Coalition, 2024).
Recommendation: Continue to invest in expanding early support hubs for young people, building on the 70 currently in operation, as well as the rollout of mental health support teams (MHSTs) in all schools. Together, these will take us closer to a comprehensive system of support for children and young people’s mental health.
Expanding offers within the NHS Talking Therapies programme
Context: The number of referrals to the NHS Talking Therapies programme has more than doubled over the last decade. Although efforts have been made to widen access, we know that
certain groups are consistently underrepresented in NHS Talking Therapies, including people from racialised communities (NHS Race and Health Observatory, 2023), older adults (Prosser et al., 2024), and people presenting with complex needs (Bell and Pollard, 2022).
Recommendation: First, address the gap in service provision for people with complex or severe needs. This would involve establishing a new service dedicated to supporting people with complex or severe needs to run in parallel with the NHS Talking Therapies programme.
Second, meet increasing demand through careful implementation of digitally enabled therapies (DETs) as a complement to, but not a replacement for, existing provision. NICE-recommended DETs could save thousands of NHS therapist hours and early economic analysis suggest that these technologies could be cost-effective (NICE, 2024a).
Expanding Individual Placement and Support (IPS) employment services
Context: People living with severe mental illness are more likely to be excluded from employment; when in employment, they are more likely to experience discrimination and inequality at work.
Being out of work also poses a risk to mental health.
Unemployment, job and financial insecurity, and recent job loss are risk factors for suicide attempts (World Health Organisation, 2024).
Individual Placement and Support (IPS) is by far the most successful and cost-effective approach to supporting people with mental health difficulties, and many other groups of disabled people, into paid work.
Recommendation: Sustain the current expansion of IPS until everyone living with a mental illness has ready access to IPS when and where they want it.
Providing alternatives to hospital admission in a mental health crisis
Context: Mental health crisis care is struggling to meet rising levels of need and severity, especially among children and young people. This is leading to protracted waiting times in A&E, pressure on mental health inpatient services, and the continued use of out-of-area placements due to a lack of local provision.
Recommendation: Invest in alternatives to acute inpatient mental health care. This should build on the six current neighbourhood 24/7 community pilot sites and draw on the wide range of alternatives to hospitalisation for people experiencing a mental health crisis.
Investing in mental health care is essential, and it will be more effective in all areas if it follows these key principles:
- Take a holistic approach to mental health care: Acknowledge and address key social
determinants of poor mental health including welfare issues, such as financial security and
housing. Adequate provision of welfare advice is likely to improve mental health outcomes
and produce additional benefits like reducing stays in hospital, preventing homelessness, and
avoiding relapse. - Offer tailored and flexible support: Maximise accessibility of effective interventions and reduce attrition rates by allowing choice and flexibility to service users, including where they receive support (for example online or in person), and how the support is delivered.
- Provide adequate mental health support in later life: Improve provision of and access to
tailored mental health care for older adults. With an ageing population, it is an imperative over
the next ten years that we see a greater focus on meeting the mental health needs of older
citizens. - Build a stronger mental health workforce: Prioritise staff wellbeing through adequate funding of mental health services. Without sufficient resourcing and capacity, mental health systems will continue to struggle, and our proposed investment areas are unlikely to produce the intended benefits.
