Mental health performance target needed to address "appalling treatment gap"

The NHS Alliance is urging the government to introduce a new NHS mental health performance target for children and young people (CYP) to help address an "appalling treatment gap" for people with mental ill health who can’t access care.  

The call comes as official data suggests that despite significant progress in many trusts there are still more than 90,000 people up to the age of 18 with mental ill health waiting more than two years following a referral for their first meaningful contact with NHS specialist community mental health services in England. Between December 2025 and February 2026, around 70% of CYP with a mental health need, had to wait over four weeks (see notes to editors). 

The NHS Alliance says an official four-week standard from first referral would make the NHS and government more accountable to improving access to treatment support for CYP at an earlier stage of their mental health illness, shine a spotlight on the progress the NHS needs to make, and facilitate access to additional investment and support where needed. 

The move follows a major conference in Birmingham last week for more than 200 mental health leaders, run by The NHS Alliance, on the future of services and to share good practice. 

Findings from a survey carried out by the NHS Alliance show many are concerned about the impact of growing demand and financial pressures on the quality of services.

Nearly two thirds (64%) of those who responded said finances would be tougher this year than last year, 94% said they were concerned or very concerned about increasing demand and 61% said they were worried about the impact financial pressures would have on the quality of care.

 The director of The NHS Alliance’s Mental Health Network, Rebecca Gray, said:

"Mental health is centre-stage in national debate and is fundamental to what the government is trying to achieve.

"There is growing recognition of its key role in supporting economic activity, education and public wellbeing.

"But despite being an important element in the 10-Year Health Plan, mental health has less visibility than other NHS pressures.   

"Ongoing mental health prevalence and service reviews may help shift the dial, but it is important that conclusions are translated into action if we are to address the appalling treatment gap faced by people with mental ill health.

"If that means targets in relation to people, particularly young people, being able to access the mental healthcare they need, bring it on.

"We know the sector faces major challenges – we recognise the importance of accountability and ensuring lessons are learned when things go wrong.

"We want the same accountability, and visibility, for waiting times as the hospital sector. 

"But let’s also learn from the extraordinary successes that are being delivered, often without fanfare, which underline the fact that meeting the mental health needs of the population is not an “add on” to addressing pressure elsewhere in the NHS; it is a core part of the solution.

"Mental health leaders deserve recognition for the progress they are making, and support to think radically about what is possible to better serve our communities."

Notes to editors

•    A new official mental health dataset shows 90,594 waiting more than 104 weeks for meaningful engagement with services.
•    "Meaningful" here means having an assessment and a care contact – leading to a "clock stop". 
•    About 31% of CYP with mental health issues who received meaningful contact within Nov 25 - Jan 26 were seen within 4 weeks. 
•    This excludes those with neurodiversity, autism and gender issues.  
•    Data on CYP mental health waiting times has only been published since April 2024 and the ability to disaggregate it by those with CYP with mental health problems, autism, neurodiverse conditions and gender issues has only been available since October 2025. As with all early data collections, there may be limitations in completeness and accuracy, and the dataset is expected to be refined over time.
•    The proposed target from The NHS Alliance does not include services for autism, ADHD or gender identity support. Although members are working hard to reduce the extremely long waiting lists for these groups, achieving a four week waiting time standard is unfortunately - for the time being - not realistic.
•    Nearly 50 MH leaders responded to our survey, carried out over a 3-week period last month. The great majority were trust leaders including chief executives, chief finance officers and chief operating officers.
•    Information on work of NHS mental health services here, here and here.