The referral went in months ago. Since then: one acknowledgement letter and nothing else. Meanwhile the thing you were referred for has not paused politely to wait its turn.
Waiting is the part of NHS mental health care people are least prepared for. Here is what helps, starting with what costs nothing.
What you can start this week without a referral
Some NHS mental health support needs nobody’s permission.
NHS Talking Therapies (England). You can refer yourself. The NHS says that “for many mental health problems, such as anxiety and depression, you can refer yourself to NHS talking therapies without speaking to a GP.” It covers anxiety, panic, phobias, depression, OCD, PTSD and coping with a long-term physical condition, for people in England aged 18 or over — 16 or 17 in some areas. Find your local service through the NHS Talking Therapies page.
Two caveats. Self-referral does not cover eating disorders, bipolar disorder, psychosis, personality disorders or substance problems, which need a GP referral. And it has its own waiting list, usually shorter than a specialist service’s — so joining while you wait for something else is often worth doing.
Your local Mind runs peer support groups, courses, drop-ins and sometimes counselling, often free and usually without a referral. What is available depends on where you live. Drug and alcohol services take self-referrals almost everywhere. Your workplace may have an employee assistance programme offering counselling within days, paid for by the employer.
What to do with the wait itself
Mind’s guide to coping on a waiting list for therapy is the most practical thing written on this. The parts that matter most:
- Keep a record of mood, sleep and what helped. It makes your eventual assessment better, because you will describe patterns rather than recall a bad month.
- Deal with the practical things underneath. Money, housing, debt and work problems all make mental health worse, and Citizens Advice can help with them.
- Protect sleep, movement and food. None is a cure; all change how bad the bad days are.
- Use structured self-help. Guided workbooks and apps have a beginning and an end. Scrolling does not.
- Find one other person — a peer group, a helpline, or a friend who knows. Isolation is what makes waiting dangerous.
Use the time to prepare: write your medication history and examples of how symptoms affect work and relationships. See what happens at a first appointment.
Go back to your GP
People assume that once the referral is in, the GP’s job is done. It is not. Your GP can start or change medication while you wait, treat things making it worse such as sleep problems or a thyroid issue, issue a fit note, tell the service your condition has changed, and refer you somewhere additional.
Book a review specifically to say: this has got worse while I have been waiting, what can we do meanwhile. Mind’s page on getting help from your GP has good advice on that conversation, including asking for a longer appointment.
How to chase a referral
Confirm it was received. Ring your surgery for the date it was sent and where to, then ring that service and ask whether they have it. Referrals get lost, and months of waiting sometimes turn out to be waiting for something that never arrived.
Ask the service directly. Mind’s advice is that “you can always ask the service provider for an update about how long you might need to wait.” Ask where you are on the list and whether there is a cancellation list. Say if things have got worse: a referral is triaged on the information in it, and your GP can update it.
Use PALS. Every NHS trust has a Patient Advice and Liaison Service, independent of the clinical team and more effective than another call to a booking line.
The 18-week right. For consultant-led, non-urgent treatment the NHS says the maximum wait is 18 weeks, and that “you have the legal right to ask to be seen or treated by a different provider if you’re likely to wait longer than the maximum waiting time specified for your treatment.” The guide to NHS waiting times explains how to raise it. Not all mental health services count as consultant-led, so ask whether yours does.
Right to Choose, described accurately
Right to Choose is discussed online as a shortcut. It is a real legal right, but narrower than the internet suggests. In England, the GOV.UK NHS Choice Framework says: “If you’re referred for consultant-led treatment, or to a mental health professional, you can decide which provider you would like to receive care from as an outpatient.” These choices “apply to both physical and mental health, but only apply at the point of referral.”
So it covers your first outpatient appointment after a referral from primary care, to a provider holding an NHS contract, and the care is NHS-funded. It does not apply to an onward referral within a service already treating you, to urgent, emergency or crisis services, to anyone detained under the Mental Health Act 1983, to prisoners, to serving armed forces members, or to maternity services. You exercise it by asking your GP to refer you to a named provider — though your GP still has to agree a referral is appropriate: the right is about where, not whether.
The NHS notes that in England you can use Right to Choose to look for autism services with shorter waits, which is why it comes up so often for ADHD and autism assessments. It is useful there, but it is no universal fast pass.
Crisis routes are a separate system
A waiting list does not mean waiting when things become urgent.
If a life is at risk, or you cannot keep yourself or someone else safe, call 999 or go to A&E. For urgent help that is not an emergency, call NHS 111 and choose the mental health option — the NHS says 111 will direct you to the right place and you may be able to speak to a trained mental health professional. Samaritans are on 116 123, free, at any time. The NHS lists these and other options under where to get urgent help.
Most areas have a 24-hour crisis line. Look it up now.
Where paying privately helps, and where it does not
Paying privately can genuinely shorten the wait for assessment and diagnosis and for medication decisions. A private consultant psychiatrist can assess you, diagnose, start treatment and write it up within weeks. At Happy Clinic, appointments are often available within a few days, depending on clinician availability. For adult ADHD and autism, where NHS waits are often longest, that is the main reason people pay.
It does not help with everything. It does not buy NHS therapy, and Happy Clinic does not provide therapy itself, although it can advise on the right pathway. It does not provide crisis care. It does not move you up an NHS list, though a private report can be useful evidence when you go back. And it does not oblige your GP to take over prescribing: for ADHD that is negotiated through a shared care agreement, and the GP decides. It also costs money not everyone has — see what it costs and the current fees first.
If you cannot pay: self-refer to Talking Therapies today, ring your local Mind this week, book a GP review for medication and a fit note, chase the referral, and save the crisis numbers to your phone. None of that is as good as the appointment you are waiting for, and all of it beats waiting quietly.
For a fuller comparison, read NHS or private, or see the conditions page and book a consultation.
Speak to a Consultant Psychiatrist
Book a secure video consultation with Happy Clinic. No GP referral needed, with appointments usually available within days.
This article is general information and is not a substitute for personal medical advice. If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.