Professor Fonagy’s Independent Review provides an important opportunity to rethink how we understand and respond to mental health in England.

It confirms that mental distress is rising, that too many people are struggling to access timely support, and that our current system is not responding adequately to people’s needs. As the national voice of mental health charities providing services, we welcome the review’s ambition, particularly its recognition of the role of community provision. The challenge now is ensuring that its recommendations translate into meaningful change through the Government’s forthcoming Mental Health Strategy.  

What the review found: 

• Mental distress has risen sharply: the proportion of adults experiencing common mental disorders has risen from 15.5% to 22.6% since 1993, with particularly significant increases among young women.  

• The severe mental illness treatment gap persists: rates of severe mental illness are stable, but outcomes remain among the poorest in society. 

• Rising demand reflects genuine need: the review challenges the suggestion that overdiagnosis explains rising demand and highlights the need for more timely, appropriate support.  

• Waiting causes harm: more than seven in ten people waiting over six months get worse. 

• The loss of community provision is part of the problem: cuts to youth and community services have weakened opportunities for early support, connection, and prevention, and are named as a driver of loneliness and distress. 

• The voluntary sector is part of the answer and community organisations are essential to reform: the review recognises the need for long-term, sustained investment in voluntary organisations and their inclusion in neighbourhood teams. 

Community provision must be at the heart of reform 

We welcome the review’s recognition that voluntary and community organisations must play a greater role in delivering mental health support. This is something we have consistently called for, and it reflects the work that mental health charities are already doing in communities across England. 

Through our involvement in the 24/7 Neighbourhood Mental Health Centres programme, we are seeing what can be achieved when NHS services, local authorities, and voluntary organisations work together to provide accessible, joined-up support. Yet too often, community organisations remain dependent on short-term contracts that make it difficult to retain skilled staff, plan services, and sustain the trusted relationships that effective support depends upon. 

Multi-year commissioning must become the norm, with mental health charities recognised and funded as equal partners in neighbourhood health rather than treated as an addition to statutory services. Our Charity Commissioning Charter provides a practical foundation for how this can be achieved. 

Needs-led must mean genuinely needs-led 

The review is clear that people seeking help were never the problem: rising demand reflects a system that has made diagnosis the only key to support. Moving away from that model is the review’s most important shift. But the proposed shift must open doors, not become a new threshold. We welcome the commitment that no one should leave a waiting list without help being actively arranged, not simply signposted. Much of that support will come from charities, which must be resourced to provide it. This must complement, rather than replace, timely access to specialist support for people with severe mental illness. 

Tackling inequalities must be a measure of success 

The review shows that those with the highest need are often least likely to get support. Reducing inequalities in access, experience and outcomes should be an explicit measure of success in the new Mental Health Strategy, and local systems should be required to show progress for the communities least well served. Community organisations, with their trusted local relationships, are essential to reaching them. 

Data must recognise the whole mental health system 

We welcome the review’s call for better, more regular data on mental health prevalence and outcomes. However, national data continues to provide an incomplete picture of the mental health system, particularly where support is delivered by charities and social enterprises. 

Through our developing Mental Health Data Observatory, we are working to bring together national and local evidence to improve understanding of mental health need, services, and inequalities. 

The Government’s national data and evaluation framework must recognise the contribution of NHS, local authority, and voluntary sector services, and ensure that new digital access routes connect people to community support as well as clinical provision. 

Dania Hanif, Interim Chief Executive of the Association of Mental Health Providers, said: 

“Professor Fonagy’s review challenges us to think differently about how we respond to mental health, but also about the kind of system we want to build. We have spent decades organising support around services, diagnoses, and thresholds, when people’s lives and the circumstances affecting their mental health are far more complex. 

“The Government does not need to start from scratch. Across England, mental health charities have spent decades building the relationships, expertise, and services that make early, community-based support possible. Our experience of the 24/7 Neighbourhood Mental Health Centres programme shows the potential of bringing that expertise together with statutory services, but these partnerships cannot succeed if charities remain an afterthought in decisions about funding, commissioning, and service design. 

“The forthcoming Mental Health Strategy is an opportunity to change that. If we are serious about moving towards prevention and earlier intervention, we must be equally serious about who delivers that support, how it is funded, and who gets to shape the decisions. Community provision should not sit at the margins of mental health reform; it must be central to how we design and deliver it.”