A New Prime Minister, and an Old Promise to Mental Health

Andy Burnham became Prime Minister just over a week ago. On the same day, my own professional body, BACP, published an open letter to him — asking that counselling and psychotherapy be recognised as a genuine, central part of the country's mental health infrastructure, not an afterthought bolted onto physical healthcare.

I've been sitting with that letter since.

A promise I've heard before

Burnham isn't new to this conversation. Long before Downing Street, as Mayor of Greater Manchester, he talked about wanting mental health support to be a genuine first port of call — counselling, exercise referral, debt advice, bereavement support — rather than reaching for a prescription pad by default. He's talked about wanting parity between mental and physical health for years. He's called children's mental health waiting times shameful.

I want to believe all of that. Most of it, I do.

It's not that GPs aren't listening

I want to be really clear about something here, because it matters to me: I don't think GPs are the problem. Most of the GPs I come across are doing a genuinely difficult job, well, under conditions that make deep listening almost impossible — a ten-minute appointment simply isn't built for someone to properly unpack what's going on underneath a low mood or constant worry. Medication can be handed over faster than a referral can be made, not because it's the easier option morally, but because it's often the only realistic option inside the time they're given.

That's not an argument against GPs. It's an argument for mental health care existing properly alongside them — with the time, space, and continuity that a ten-minute slot was never designed to hold.

"Free" isn't quite the whole story

There is a free, national option — NHS Talking Therapies, which anyone in England can self-refer into. I don't want to pretend otherwise. But it's generally short-term and structured around common presentations like anxiety and low mood, with real waits attached, and longer-term or more complex work is often subject to further waiting lists on top of that.

That's part of a wider gap community services like Number 22 Community Counselling Services — the Maidenhead and Windsor charity I trained with, and still work alongside today — have historically tried to fill: sustained, relational, low-cost counselling, run through fundraising and volunteer goodwill rather than guaranteed public funding.

But even that's changing. Number 22 recently had to move to a 12-session cap of its own — not far off what NHS Talking Therapies can already offer for more complex presentations. I don't think that's a failure of Number 22; it's what happens to community provision when funding doesn't keep pace with demand. And it points to something worth sitting with: short-term therapy is genuinely, reliably helpful for a lot of people. It's not enough for everyone. Some people are working through things — longstanding trauma, patterns years in the making — that don't resolve in twelve sessions, however well those twelve sessions are used.

When both the NHS and the community charities that used to offer an alternative are being pushed toward the same short-term shape, the people who need something longer are left with a shrinking set of options: brief NHS support, a now-brief charity option, or private therapy — open-ended, but realistically only available to those who can pay for it.

I spent three years at Number 22 working with adults, and I still support them now in secondary schools with teenagers, because I still believe deeply in what they offer, even in its current, more limited form. But the space for genuinely longer-term, low-cost work is narrowing, not widening — and that's worth naming honestly rather than pretending otherwise.

Something I sit with in my own work

I'll be honest about something else, too: most of the people who come to my own private practice can afford to pay for it. That's simply the reality of private counselling, and I don't think it's helpful to pretend it's more universally accessible than it is. Because with rising cost of living and increasing professional outgoings, counsellors need to make a living too.

What would actually tell us something

Burnham has said the right things about mental health for a long time. What would genuinely change things isn't more good will from counsellors and charities already stretched thin — it's public funding that lets sustained, longer-term talking therapy exist properly, wherever someone happens to live, rather than everyone being quietly pushed toward the same short-term shape because that's what the budget allows.

I don't think it's my place to tell you what to make of a Prime Minister a week and a half into the job — and this isn't really a post about politics. It's a post about whether the conversation my profession has been having for years is finally about to be matched with something real, for the people who need more than twelve sessions, not just the ones for whom that's genuinely enough.

I'll be watching what actually gets funded, not just what gets promised.

Kelly