NHS spending on mental health, learning disability and autism services has grown from £12.5 billion in 2018-19 to £20.6 billion in 2025-26 (NHS Mental Health Dashboard). Yet this enormous growth in investment has not kept pace with demand.
Mental health has featured in NHS planning documents for decades. What has changed in 2026 is the degree of political weight behind the commitment and the structural changes now being built around it.
In May 2026, the government launched a call for evidence to shape a cross-government mental health strategy, the first of its kind. The remit spans health, education, employment and communities. This followed the December 2025 appointment of Professor Peter Fonagy to chair an independent review into mental health conditions, ADHD and autism, and the 10-year plan’s explicit commitment to transform mental health services into 24/7 neighbourhood care models.
For pharmaceutical and medtech companies, the question is what this prioritisation of mental health actually means in commercial and clinical practice: where is demand growing fastest, what does the new commissioning and access landscape look like, and where can industry contribute meaningfully?
Around 1 in 5 adults in England now have a common mental health condition, up from around 1 in 7 in 2007. The Centre for Mental Health’s Big Mental Health Report 2025 puts the total economic and social cost of mental ill health in England at £300 billion a year: roughly double the entire NHS budget. That figure encompasses lost earnings, reduced quality of life, costs to businesses and state expenditure across departments beyond health.
Children and young people represent perhaps the most acute pressure point:
The workforce target offers a partial counterpoint: the government has met its goal of recruiting 8,500 additional mental health workers three years ahead of schedule, and £473 million over four years has been committed for mental health emergency departments, community centres and capital investment. But the NHS Confederation’s Investment Priorities for Mental Health 2025 notes that mental health’s share of NHS funding has actually declined even as demand rises, from 8.78% in 2024-25 to 8.71% in 2025-26. The gap between what the system needs and what it currently has is not closing fast enough through workforce and capital spending alone.
The 10-year plan’s “sickness to prevention” shift is highly applicable to mental health. Seventy-five per cent of mental health problems are established by age 24. Earlier intervention means lower long-term cost to the individual and the system, but prevention has historically been difficult to fund because the benefits accrue over years, while NHS budgets are managed year by year.
Two structural changes are beginning to help solve that problem. First, the cross-government strategy explicitly embeds mental health in housing, education and employment policy, creating a framework for investment that does not depend entirely on NHS spending decisions. Second, the neighbourhood health model, with six neighbourhood mental health hubs being piloted across England in 2025, moves assessment, treatment and support closer to communities and out of hospital settings where they have historically been delivered at greater cost and with poorer outcomes.
People with serious mental illness have a life expectancy 15 to 20 years shorter than the general population, largely due to preventable physical conditions. The bidirectional relationship, where mental health problems worsen physical outcomes and physical illness worsens mental health, means that failure to invest in mental health drives cost across the entire NHS, not just in mental health services.
The commercial relevance of this extends well beyond companies working in mental health. Across every therapeutic area, patients living with mental health conditions experience worse clinical outcomes: they are less likely to report symptoms early, less likely to adhere to treatment, and more likely to present late when conditions have become harder and more expensive to treat. For pharmaceutical companies developing medicines in oncology, cardiovascular disease, diabetes, respiratory conditions and beyond, mental health comorbidity sits at the centre of why certain patient populations consistently underperform against the outcomes clinical trial evidence would predict.
The populations most affected are also those the NHS 10-year plan explicitly commits to reaching. Each faces compounded disadvantage: higher rates of mental health conditions, worse access to diagnosis and treatment, and greater risk of physical health consequences going undetected:
These are not niche populations in the context of NHS commissioning. They represent a substantial share of the patients any company targeting NHS scale needs to understand and reach. Evidence packages, market access strategies and NHS partnership programmes need to account for mental health comorbidity in the populations they are designed to serve. A medicine or technology that works well in a trial population that systematically excludes people with mental health conditions will face a credibility gap when its real-world NHS performance is assessed against patient populations that are considerably more complex. Commissioners are increasingly aware of this gap, and NICE’s evaluation frameworks are beginning to reflect it.
NICE has named mental health as one of its priority areas for evaluation in 2025-26, alongside early cancer detection, diabetes, musculoskeletal conditions, women’s health, respiratory and neurology. Topics selected by the NICE Prioritisation Board are more likely to progress through the HealthTech Programme or Technology Appraisal process, and evaluation in a named priority area opens the route to the National HealthTech Access Programme for health technologies, or the standard NICE appraisal funding mandate for medicines. For pharmaceutical companies, mental health medicines entering appraisal now do so in a commissioning environment where the economic case for investment is more firmly established than it has been. Committees and commissioners increasingly want to see how a medicine performs within NHS care pathways and what it delivers for patient-reported quality of life, not just primary endpoints.
Novel mechanisms in treatment-resistant depression, psychosis, ADHD and anxiety disorders are entering or approaching NICE appraisal. The NHS’s stated commitment to parity between mental and physical health, combined with the political weight of the new cross-government strategy, creates a more receptive commissioning environment for medicines that can demonstrate both clinical and economic value. NHS spending on antidepressants in 2023 was £217.5 million. Against the £300 billion total cost of mental ill health, and Deloitte’s finding that every £1 invested in workplace mental health support returns £5.30 through reduced absenteeism and presenteeism, the economic case for investment in effective treatment is well established.
The neighbourhood health model also has implications for medicines access. As mental health services shift into community settings and primary care networks take on a greater commissioning role, prescribing decisions will increasingly be made by GPs and community practitioners rather than secondary care specialists. The clinical evidence matters, but so does how a medicine fits into a primary care pathway, what support is available to prescribers, and whether the patient support infrastructure exists to drive adherence in a community setting.
Mental health is the leading category within the NICE HealthTech Programme’s priority list. With over a million people waiting for mental health support and services already at capacity, technologies that can extend reach, reduce waiting times or deliver evidence-based interventions at scale have a clear system case. The product categories with the strongest fit include:
The neighbourhood mental health hubs need to function at community scale, which means technologies need to integrate into primary care workflows, connect to secondary care data, and be usable by a broad range of practitioners rather than specialists only. Commissioning channels are also expanding through the 10-year plan’s ‘Talking Therapies’ programme and the inclusion of Mental Health Support Teams in Schools in the Mental Health Investment Standard for the first time in 2025-26, opening a procurement route for digital tools targeting children and young people.
None of the strategic signals above automatically translate into commercial opportunity. The companies that succeed will be those that understand the system’s pressure points, not just where their product fits clinically. In mental health, the problems are well documented: long waits, capacity constraints in community services, the mental-physical health gap, and inequitable access for children and young people and for minority ethnic communities. A medicine or technology that demonstrably addresses one of those problems, in a way that is measurable and affordable at ICB level, has a genuine case.
Engagement with the cross-government strategy call for evidence, closing on 10 July 2026, and with the Fonagy review’s process, is an opportunity to shape the framework before it is set. The evidence submitted will influence the commissioning priorities, service models and outcome standards that follow. For companies with relevant data, clinical insight, or delivery experience in mental health, contributing to that process could be valuable market-access work and a useful contribution to the future of the NHS.
CHASE works with pharmaceutical, medtech and digital health companies on NHS commercial strategy and NHS–Industry Partnerships, including in mental health. Our NHS–Industry Partnerships team designs and delivers collaborative programmes connecting industry partners with NHS organisations across primary, community and specialist mental health settings.
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