Spending Is Not the Same as Working

In May, it was announced that NHS mental health funding will reach £16.1 billion by 2026-27, an increase of £140 million in real terms. This includes £473 million over four years to support emergency departments, community hubs, and school teams. Recruitment of 8,500 new mental health staff has also been brought forward.

Yet, in March, Parliament was told that mental health's portion of the overall NHS budget fell again - from 8.78% to 8.68% - with forecasts pointing to a further dip to 8.4%.

Both facts are correct. But the real question is not who has the biggest slice; it is whether the spending is making any real difference.

The only number that settles the argument

If investment were working, the curve would be bending. Instead, more than one in five people aged 16 to 64 has a common mental health condition in England - 22.6%, a 20% increase since 2014. Among young people, it is closer to one in four. The Mental Health Foundation's June 2026 report, following 40,000 individuals over 15 years, found 4.8 million more people living with poor mental health than after the 2008 crash - a 17% rise. Nearly one in three young people, 31%, report poor mental health, compared with 23% of those over 25.

Service data tell the same story. In the quarter to March 2025, 385,540 children and young people awaited first contact with community mental health services - a 14.4% rise year on year. Emergency mental health referrals for children increased 10% between 2023 and 2024. Median waits for CAMHS hover around eight months; at the ninetieth percentile, waits stretch beyond two years.

We are left with record cash and record staffing, yet the population's mental health continues to decline. This is not simply an issue of funding but of effectiveness. That conversation is harder, but necessary.

The one thing that is scaling

One part of the system is growing rapidly: prescriptions.

Antidepressant prescribing has risen by over 40% since 2020, costing the NHS £1.23 billion in that time. Over 428 million items were dispensed between March 2020 and March 2025. In 2024 alone, over 91 million prescriptions were issued - the highest annual total on record.

ADHD medication prescribing is rising at an even faster rate. In just one quarter of 2025-26, there were over one million prescriptions written - a 5% increase on the previous quarter alone, costing £45 million in three months. Between 2023-24 and 2024-25, the number of adults prescribed ADHD medication increased by nearly a quarter, with prescriptions for lisdexamfetamine rising 36% in the space of a year.

And then there is the figure that ought to stop everyone in their tracks.

For children aged five to twelve, antidepressant prescribing rose 41% between 2015 and 2021.

Five. Not fifteen. Most people do not even realise antidepressants are prescribed to children that young, let alone that the number has risen so sharply in six years. It is worth sitting with that fact before moving on.

Let me be clear: medication works and can be life-changing. No one should stop a prescription because of numbers in an article. The point is what a strained system reaches for most readily. A prescription can be handed out in ten minutes, while therapy requires appointment availability, a therapist, and a waiting list that stretches into months, or years. When demand outstrips supply, the system defaults to what it can deliver quickly.

The fastest-growing part of the mental health system is the part that requires the least of it.

So this pattern shows us more than ineffective spending. It shows a system that leans on what it can execute, while the support these same young people are waiting for lags behind.

Activity is not outcome

Government figures on funding, staffing, or prescriptions measure inputs, not outcomes. Prescription numbers, like money allocated or staff hired, tell us what the system has done - not whether anyone has improved. The data that matter most - prevalence rates, wait times, recovery figures, young people returning to school or work - move slowly, and rarely make headlines. But these are precisely the numbers that should govern our sense of success.

It is the same in business. Celebrating the fact that four hundred managers trained is well-intentioned, but the real question is whether these managers lead differently when it matters most, and whether their teams stay.

Improved reporting and detection partly explain the rise in mental health figures, which is a form of progress. But soaring emergency referrals and year-on-year lengthening waitlists indicate a system struggling to keep pace with genuine need.

What this means for those waiting

Two-year waits are little consolation to families caught in the queue. Resourcefulness can only stretch so far; true support is most needed at the point of referral, and most glaringly absent there. Another announcement of increased funding does not answer that need, and nor does a prescription offered because it is the only thing available this month.

Support must be judged by its effect, not its promise.

The harder question

The real debate is not about how much the government spends. Rather, it is whether the approach currently in use - at any level of funding - is capable of turning this around. A decade of evidence suggests the answer is probably no. Simply pouring more money into an ineffective model will not bend the curve.

Leaders, in business or government, are judged on results. What counts is not what you fund, but whether the thing you aimed to change actually changes.

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