The Royal College of Psychiatrists polled over 1,300 mental health professionals nationwide in May 2020, just weeks into the nation’s first lockdown. The results were striking. The number of urgent and emergency cases had increased by almost half. Routine appointments had drastically decreased, according to nearly as many. The concern expressed candidly in that survey was that the pandemic was causing a delayed wave of mental illness that would eventually overwhelm already overburdened services, and that the NHS was storing up a problem it wasn’t prepared to handle. After five years, that wave showed up. And a large portion of it found its way into the private sector.
Since 2020, there has been a noticeable change in UK psychiatry. The number of new private clinics that have opened in Bristol, Manchester, and London, the waiting lists that have grown from weeks to months even in private practice, and the shift in mental health discourse from the periphery to the mainstream are all indicators of this. For an increasing number of working adults, this service—which was previously mostly utilized by those with insurance or substantial disposable income—is now the easiest way to receive a diagnosis and a treatment plan that works.
A portion of the story is made clear by the NHS figures. By 2025, there were 1.79 million people on community mental health waiting lists, up from 1.56 million in 2023. Adults seeking specialized support for anxiety and depression or ADHD assessments may have to wait 12 to 18 months in some parts of England. In contrast, a new patient can usually be seen in two to four weeks at a private clinic in most large cities. That difference is significant for someone who is having panic attacks that prevent them from attending client meetings or using the London Underground. It is what separates functioning from non-functioning.
| Topic | The Rise of Private Psychiatry in the UK: What’s Changed Since 2020 |
| Primary Catalyst | COVID-19 pandemic (2020); 43% of psychiatrists reported a surge in urgent cases while routine care fell sharply, forecasting a “tsunami” of mental illness |
| NHS Waiting List (2025) | 1.79 million people on NHS community mental health waiting lists in 2025, up from 1.56 million in 2023; specialist waits commonly 12–18 months |
| Private Consultation Cost | Average private consultation rose from £96 in 2022 to £129.20 in 2025; nearly 29% of private psychologists are no longer accepting new patients due to capacity constraints |
| Private Wait Time | Typically 2–4 weeks for initial assessment; appointments range from 60–120 minutes for full assessments vs. standard NHS appointment durations |
| Biggest Growth Area | Adult ADHD and autism spectrum assessments; demand far outpacing NHS capacity, driving a significant share of private clinic referrals across England |
| Key Policy Mechanism | “Right to Choose” pathway — patients in England can legally request referral to a private provider funded by the NHS, accelerating private sector capacity since 2020 |
| Service Model Shift | Telepsychiatry normalized post-pandemic; “shared care” agreements between private psychiatrists and NHS GPs now common — private diagnosis, NHS medication management |
| Academic Psychiatry Decline | Full-time academic psychiatrists fell from 330 in 2004 to 206 in 2023 despite 50% expansion in medical school places, compounding NHS capacity problems |
| Key Concern | Growing “two-tier” system where timely mental health care is increasingly tied to income or private insurance; BMA mental health data documents ongoing psychiatry workforce shortfalls |
Since ADHD is now the most obvious cause of the growth of private psychiatry, it merits special consideration. NHS pathways have simply been overburdened by the increase in adults seeking late diagnoses of ADHD and autism, many of whom spent decades not understanding why they struggled with focus, relationships, or emotional regulation. A significant portion of this demand has been met by private clinics, which provide comprehensive 90-minute assessments as opposed to hurried checklist appointments. This has gained additional impetus from the “Right to Choose” policy, which permits NHS patients in England to request referrals to private providers at NHS expense. This has forced private providers to increase capacity more quickly than many had predicted.
All of this was made possible in large part by telepsychiatry. Before 2020, remote consultations were used sparingly and occasionally with reluctance. They were almost immediately normalized by the pandemic. It is now possible for a psychiatrist in Edinburgh to evaluate a patient in rural Devon without both parties having to travel. In between meetings, follow-up appointments can be scheduled via video call. The barriers that previously prevented people living outside of major cities from obtaining private mental health care have greatly decreased, expanding the potential patient base far beyond the central London professional class that formerly controlled the market.
One of the more sensible structural arrangements to come out of this time period is the shared care model. After seeing a private psychiatrist for diagnosis and initial medication stabilization, patients return to their NHS GP for continued prescriptions. It’s a practical compromise that recognizes the shortcomings of the NHS’s current capacity as well as the fact that most people cannot afford to pay for private care indefinitely. It’s a different question, and one that isn’t always raised loudly enough, whether general practitioners are always at ease with this arrangement—being given responsibility for drugs prescribed by a physician they’ve never met.
It is now more difficult to ignore the cost picture. In the UK, the average cost of a private psychiatric consultation increased from approximately £96 in 2022 to over £129 by 2025. That is a significant rise. Additionally, nearly three out of ten private psychologists now say they are at capacity and aren’t taking on new clients. This situation is similar to the NHS capacity issue that initially prompted people to turn to the private sector. The irony of this is difficult to ignore: a system that people used because the NHS was overcrowded is now overcrowded.
However, the social significance of obtaining private mental health care has changed the most. Admitting that you were paying a psychiatrist in private was still unsettling five years ago because it was thought to indicate either privilege or desperation. The discomfort has mostly subsided. Nowadays, people talk about it in the same register as they talk about going private for a physiotherapy referral or changing general practitioner practices. People who couldn’t wait and could barely afford not to made this practical decision under practical pressures. Naturally, the people who couldn’t afford it either way are the ones for whom neither system is currently effective and for whom the growing gap between what is available with money and what is available without it is widening rather than narrowing.