The UK must decide if good mental healthcare is a priority or a privilege, the outgoing Royal College of Psychiatrists (RCPsych) president has warned, cautioning that unless changes are "made today," those with mental illness will become sicker, hospitals will remain full, and tragedies will continue to happen.

In her valedictory speech, at the college’s International Congress in Liverpool, Dr Lade Smith called on the UK government and all political parties to combine their efforts and close the treatment gap, "to make good mental healthcare a priority for all, rather than a privilege for some."

Staffing and Waiting Lists 

People with mental illness can wait years for a diagnosis, care, and treatment, only to be seen by services that are overwhelmed and understaffed. A recent RCPsych workforce census found that 27% of consultant psychiatrist posts in England were either vacant or filled by temporary staff at the end of March 2025. 

Around 1 million people were waiting for mental health services in England, according to the 2024 Darzi report, commissioned by the government. According to RCPsych, the latest figure stands at 1.8 million. 

Smith said many more in need of care never came into contact with services at all. Those who do not access the right support are increasingly likely to become more unwell, become isolated, and fall out of education or work, she said. 

"We know we can effectively treat mental illness but frankly, we are not commissioned to do so," she said, noting that essential NICE-recommended treatments exist but are not being commissioned.

Funding Falls Short of Disease Burden 

Smith identified the forthcoming mental health strategy for England as an important opportunity to drive a shift towards prevention and offer earlier treatment and support. However, this must be supported by an expanded mental health workforce and adequate funding, she said. 

Mental health accounts for more than 20% of the disease burden but less than 10% of NHS expenditure, the Darzi report found.

“It is now time for the country to decide if we want people to receive effective treatments delivered by world class services or if we want to risk wasting the potential of an entire generation by continuing to fail to prioritise mental healthcare,” 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.