Finding mental health support can feel complicated. There are multiple routes, unclear eligibility criteria, and confusing terminology. This guide breaks it down into clear steps so you know what to do next.
Estimated reading time: 7 minutes
This guide is written for England and focuses on NHS services in England. It provides general information, not medical advice, and it does not replace speaking to a GP or other healthcare professional. Contact details, wait times, and costs were accurate at the time of writing but may change.
If you are in crisis, refer to the support options in Step 6.
What this guide covers:
- Step 1: Decide what type of support you need
- Step 2: Understand the NHS pathways (England)
- Step 3: What to say to your GP
- Step 4: Self-referral options (no GP needed)
- Step 5: Private therapy and counselling
- Step 6: Crisis support (if you need help now)
- Step 7: What to do while you are waiting
- Common questions
- Next steps
Who this is for: Anyone looking for mental health support in England, whether for yourself or someone you care about.
Step 1: Decide what type of support you need
Not all mental health support is the same. Knowing what you are looking for makes the process easier.
Common types of support
Talking therapies (counselling, CBT, psychotherapy)
- One-to-one sessions with a trained therapist
- Focus on specific issues or general wellbeing
- Often offered as a time-limited course of sessions
Medication (for example antidepressants)
- Prescribed by a GP or psychiatrist
- Often combined with talking therapy
- It can take a few weeks to notice an effect
Peer support (support groups, online communities)
- Shared experiences with others
- Less formal than therapy
- Can be face-to-face or online
Crisis support (urgent help)
- For urgent situations or thoughts of self-harm or suicide
- Available 24/7 (varies by service)
- Phone, text, or online
If you are not sure what you need: A GP is a good first step.
Step 2: Understand the NHS pathways (England)
The NHS offers free mental health support, but routes vary depending on what you need and what is available locally.
Route 1: GP support and referral
What it is: Your GP listens, assesses what is going on, and helps you access the right next step.
When to use this:
- You are not sure what support you need
- You want to discuss medication alongside therapy
- You have complex or longer-term mental health needs
How it works (typical):
- Book a GP appointment (phone or in-person)
- Describe what has been happening and how it is affecting day-to-day life
- The GP may suggest self-help, prescribe medication, refer you to NHS Talking Therapies, or refer you to other NHS services
- You will be told what happens next and how you will be contacted
Wait times: These vary by service and area. Some routes are quick. Others can take weeks or months.
Route 2: Self-referral to NHS Talking Therapies
What it is: In many areas, you can refer yourself directly to NHS Talking Therapies (formerly known as IAPT) without seeing a GP.
When to use this:
- You know you want talking therapy
- You have mild to moderate anxiety or depression
- You do not want to wait for a GP appointment
How it works (typical):
- Find your local NHS Talking Therapies service
- Complete the online self-referral form (or call)
- Have an assessment (often by phone)
- Get a recommendation for the most suitable support
What they often offer: CBT, guided self-help, group therapy, and sometimes counselling.
Wait times: These vary by area. Some services offer an assessment within a few weeks. Treatment can take longer.
Route 3: Specialist mental health services (secondary care)
What it is: Support from NHS mental health teams for more severe, complex, or higher-risk needs.
How it usually works: Access is typically via referral (for example from your GP, NHS 111, a crisis team, or a hospital team). The assessment and care plan can involve different clinicians depending on local services.
Step 3: What to say to your GP
Talking to your GP about mental health can feel awkward. This can help.
Before the appointment
Write down:
- How long you have been feeling this way
- What has changed (sleep, appetite, concentration, mood)
- What makes it worse (or better)
- What you have tried already
- What you are hoping for (therapy, medication, referral)
Example script:
“I’ve been feeling really anxious for the past three months. I’m not sleeping well, I’m worrying constantly, and it’s affecting my work. I’ve tried exercise and cutting down on caffeine but it’s not helping. I’d like to try talking therapy if that’s possible.”
What your GP may ask
- How long have you been feeling this way?
- Have you felt like this before?
- Are you having thoughts of harming yourself?
- How is it affecting your daily life?
- What support have you tried?
Be honest. These questions help the GP choose the safest next step.
What happens next
Your GP may:
- Refer you to NHS Talking Therapies
- Prescribe medication
- Refer you to other NHS services
- Suggest self-help resources or local support
- Book a follow-up appointment
If your GP is not helpful: You can book with a different GP at your practice or change practices.
Step 4: Self-referral options (no GP needed)
You do not always need a GP referral to start getting support.
NHS Talking Therapies (self-referral)
Find your local service: Search “NHS Talking Therapies” + your area, or use nhs.uk/service-search/mental-health.
Charity and voluntary sector services
Many charities offer free or low-cost counselling and support.
Examples include:
- Mind: Local Mind branches often offer support and groups
- Samaritans: A listening service (phone, email, and sometimes face-to-face)
- CALM (Campaign Against Living Miserably): Helpline and webchat for men
- Andy’s Man Club: Free peer support groups for men
How to find them: Use our services directory or search “[charity name] near me”.
University counselling services (if you are a student)
Most universities offer free counselling to students. Contact student services or the wellbeing team.
Employee Assistance Programmes (EAP)
If you are employed, check if your workplace offers an EAP. This may include free telephone counselling (often a limited number of sessions).
Step 5: Private therapy and counselling
Private therapy costs money, but it can offer faster access and more choice.
When to consider private therapy
- NHS waiting times are too long for you
- You want to choose your therapist
- You want a specific type of therapy
- You prefer evening or weekend appointments
How much does it cost?
Costs vary by location and therapist experience. As a rough guide:
- Lower-cost counselling: £10–£40 per session (for example charities, trainees)
- Typical private therapy: £50–£90 per session
- Specialist or London-based: £80–£150+ per session
Sliding scale: Some therapists offer reduced rates based on income. It is okay to ask.
How to find a private therapist
Use accredited directories:
- BACP (British Association for Counselling and Psychotherapy): bacp.co.uk
- UKCP (UK Council for Psychotherapy): psychotherapy.org.uk
- Counselling Directory: counselling-directory.org.uk
What to check:
- Professional membership or registration (for example BACP or UKCP)
- Relevant experience
- Cost and session length
- Location or online options
First session: Many therapists offer a short initial call to see if you are a good fit.
Step 6: Crisis support (if you need help now)
If you are in crisis or having thoughts of self-harm or suicide, support is available.
Crisis helplines
- Samaritans: 116 123 (free, 24/7)
- CALM (men’s mental health): 0800 58 58 58 (daily, 5pm–midnight)
- Shout: Text SHOUT to 85258 (free, 24/7)
- NHS 111: Call 111. If prompted, choose the mental health option.
Note: Opening hours and options can change. If you are unsure, check the service website.
NHS urgent mental health support (England)
Most areas have local urgent mental health support routes. If you are in severe distress or at immediate risk:
- Call 999 if there is immediate danger
- Go to A&E
- Call NHS 111
If it feels hard to do alone, ask someone you trust to stay with you and help you make the call.
Step 7: What to do while you are waiting
Waiting can be frustrating. These steps can help you cope and keep things moving.
Self-help resources
- Every Mind Matters (NHS): practical tools and personalised plans
- NHS Moodzone: CBT-based tools for anxiety and depression
Online programmes
Availability varies by area. If you are offered online support, ask what the programme is and how it works.
(Previously, some areas used services such as Togetherall. Local options change over time.)
Peer support
- Andy’s Man Club: peer support groups
- Mind: local groups in many areas
Lifestyle changes that can help
These will not fix everything, but they can help while you are waiting:
- Gentle exercise (for example a daily walk)
- A simple sleep routine
- Cutting down alcohol (it can worsen anxiety and low mood)
- Talking to someone you trust
Common questions
No. Many routes, including NHS Talking Therapies and charity support, do not require a diagnosis.
Ask about sliding scale fees, look for trainee therapists, and consider charities and local low-cost services.
In a crisis you can still use NHS 111 and A&E. For ongoing support, registering with a GP is usually the best route.
Different therapies work for different people. You can ask about alternatives, different approaches, or a different therapist.
Next steps
- Choose your route: GP support, self-referral to NHS Talking Therapies, or private therapy
- Make contact: book a GP appointment or complete a self-referral
- While you wait: use self-help tools and peer support
- If you are in crisis: use Step 6 now
Finding support is not a sign of weakness. It is a practical step towards feeling better.
Related resources:
- Understanding therapy options: Counselling, CBT, and other talking therapies explained
- How to talk to your GP about mental health
- Supporting a friend: What to say (and what not to say)
Find services near you: Get Support