England has only one consultant psychiatrist for every 2540 people expected to experience a mental illness each year, prompting warnings from the Royal College of Psychiatrists (RCPsych) that workforce shortages have become “unsustainable.”

The college said consultant psychiatrists are being pushed to “breaking point” by unmanageable workloads, with the latest RCPsych workforce census showing that one in seven consultant posts in England are vacant.

In total, 748 of 5193 consultant psychiatrist posts are unfilled, leaving many patients unable to access vital care and treatment, the college warned.

Overall, there is one consultant psychiatrist for every 12,700 people in England, according to the census.

The proportion of vacant consultant posts has risen steadily, from 10% in 2021 to 14% in 2025. In 2015 the vacancy rate was less than half the current level, at 6%.

The census also found that more than a quarter of posts (27%, 1417) were either vacant or filled by locums, reflecting growing reliance on temporary staff.

The RCPsych Workforce Census 2025 is based on responses from 40 of 48 NHS mental health trusts in England.

Situation ‘Clearly Not Sustainable’

Demand for services has continued to rise. New referrals to mental health services increased from 4.4 million in 2021 to 5.5 million a year, according to the college.

Last month the RCPsych warned of a mental health crisis of “pandemic proportions” affecting people across England.

At the same time, growth in the psychiatry workforce has slowed in recent years, meaning the situation is “clearly not sustainable,” warned Dr Lade Smith, president of the RCPsych.

The census found the highest consultant vacancy rates in eating disorder services (20%), general adult psychiatry (17%), and child and adolescent services (16%).

“It is particularly concerning to see that eating disorder and children and young people’s services are so understaffed as three quarters of mental illness occurs by the age of 24,” Smith said.

There was also significant regional variation, with vacancy rates of 18% in northern regions compared with 11% in the South.

Retention a Priority

Unmanageable workloads are leaving many clinicians overwhelmed, contributing to burnout and prompting some to reduce their hours, take early retirement, or leave the profession altogether.

“Retention must also remain a priority and ensuring that those who complete their training are encouraged to stay and work in the NHS is equally important,” Smith said.

The college has published a retention charter outlining measures aimed at keeping psychiatrists in the profession.

It also called on the government to implement steps to improve retention, including access to comprehensive mental health and wellbeing support, administrative support, reliable technology, and appropriate working space.

“We’ve provided the tools, and are keen to work with government to get this right now and for the future,” Smith said.

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.