NHS talking therapies in England
How the NHS talking therapies service for anxiety and depression works in England: who it is for, how self-referral works, the waiting-time standards and what they leave out.
In England there is a national programme, NHS Talking Therapies for anxiety and depression, which provides free psychological treatment for common mental health problems. It is the route most people use, and it does not require anyone’s permission to start.
You can refer yourself
You do not need a GP referral. You can contact the service directly, or your GP can refer you. The requirements are that you are registered with a GP and aged 18 or over — in some areas 16 or over. The NHS publishes a search that finds the service covering your postcode.
Services are free and confidential. Help is delivered in person, by video, by telephone, or as a structured online course, depending on what you need and what the service offers.
What happens next
Someone from the service contacts you — usually within a few weeks — for an assessment conversation. This is not therapy. It establishes what is going on, how severe it is, whether there is risk, and which of the service’s treatments fits.
Treatment is organised on a stepped-care basis, the model NICE guidelines describe: start with the least intrusive intervention likely to work, and step up if it does not. In practice that means guided self-help or a psychoeducational group first for milder difficulties, and structured one-to-one therapy — most often CBT, sometimes counselling for depression, interpersonal therapy, EMDR or couples therapy for depression — where the problem is more severe or the first step has not helped.
Waiting times, honestly
There are national standards: 75% of people referred should have a first appointment within six weeks, and 95% within eighteen weeks. Those are the published NHS England access and waiting-time standards.
Two caveats that matter. First, “first appointment” often means the assessment call, not the start of treatment — the wait for treatment itself can be substantially longer, and the two waits are reported separately. Second, performance varies a great deal between services, and local waits can run well beyond the standard.
If you are waiting and things get worse, tell the service. Do not wait quietly for a letter.
What the service is not for
NHS Talking Therapies is designed for anxiety disorders and depression. Other needs — psychosis, bipolar disorder, eating disorders, personality disorder, complex trauma, severe or long-standing difficulties — are usually handled by different NHS services, and the route is normally through your GP or a community mental health team. The assessment will redirect you if this is not the right service; that is not a rejection.
It is also not a crisis service. If you need help now, see getting help now.
Outside England
Arrangements differ in Scotland, Wales and Northern Ireland — self-referral is not the standard door everywhere. See therapy across the UK.