(PART 2) - System Failure: Why Mental Health Sector Fails the Public (Originally published on LinkedIn)

Dzmitry Karpuk
Jul 1
5 min read

Contents:

When Mental Health (MH) Becomes the Welfare System
The Hidden Fragmentation of Mental Health Support
The Connection Between Welfare Reform and Systemic MH Failure
Outdated MH Training and the Welfare Crisis
What is the way forward?

1. When Mental Health (MH) Becomes the Welfare System

Across the UK, we are witnessing a sharp and worrying intersection between the welfare crisis and the long-standing systemic failure of our mental health (MH) sector. As of January 2025, 39% of all active Personal Independence Payment (PIP) awards list psychiatric disorders as the primary condition, making mental health the most common reason people receive disability-related benefits. To put this into perspective, around 10–15 years ago, mental health accounted for closer to 22% of claims—and shockingly jumped from just 2% in the early 1990s!

Sources:

1. 2019–2024 – The Institute for Fiscal Studies reports mental-health-based awards rising from 28% to 37%

2. October 2016 – Mental health comprised approximately 22% of PIP (and DLA) primary conditions

3. Early 2000s – Mental health at around 27% of working-age disability claims, up from ~2% in early 1990s: https://www.neilobrien.co.uk/p/welfare-spending-and-mental-health

4. Early 1990s – Disability benefits covered ~2% of the population; rose to ~6% by 2020–21

Yet the public is still told again and again that the mental health sector is underfunded, crushed by waiting lists, and simply needs more investment. However, some suggest funding hasn't been the issue—it’s how it’s been used. A large share has gone to university-based MH training programmes that are now seen as outdated and misaligned with real-world client needs.

Supporting Sources:

1. Therapist training courses described as “toxic” and in need of regulation

2. Universities receive funding at the expense of community services

3. One in eight Oxford students sought counselling, stressing the system

2. The Hidden Fragmentation of Mental Health Support

Many people probably don’t realise is that the UK’s mental health system is deeply fractured—divided across statutory (NHS), third sector (charities & NGOs), and private sector (paid therapy) domains. These sectors do not follow the same guidelines, training, standards, or regulation. The third and private sectors are largely self-regulated, offering only an illusion of oversight—and leaving the public vulnerable.

Sources:

1. GPs are referring complex patients to unregulated charity therapists due to NHS pressures

2. Charity Commission lacks capacity to oversee front-line mental health delivery

3. Between Sessions (2025) highlights government efforts to crack down on the “unregulated private sector”, acknowledging that counsellors and psychotherapists may practice with no protected titles or oversight

4. As of August 2022, 238 private mental health providers were licensed by the CQC—64 rated ‘requires improvement’ or ‘inadequate’

3. The Connection Between Welfare Reform and Systemic MH Failure

As written in Part 1 (previous article ), universities have become a new upper class in the MH system—shaped by activist agendas that determine what research is funded and who decides what counts as evidence. This has resulted in an overproduction of research that often lacks clinical relevance—widening the gap between trauma/crisis needs and academic messaging.

It’s widely accepted that individual 'talking therapies are the gold standard' in trauma care, reinforced in training, media, and popular culture. However, newly qualified therapists quickly realise these methods often do not work for clients in crisis. Many retreat to narratives blaming “oppression, discrimination, austerity.” But could this be collective avoidance? Therapists are trained to work with avoidance in clients—maybe it's time to apply the same scrutiny to our field?

Sources:

1. REF-driven incentives encourage volume over clinically meaningful research

2. Universal school mental health programmes (CBT/mindfulness) have limited evidence and possible harm

3. Rise in referrals to unregulated charity therapists due to NHS strain

4. NICE recommends only trauma-focused CBT and EMDR for PTSD (Here + more here)

Yet a 2025 NHS evaluation of a London trauma service found only 40.8% recovery with CT-PTSD and 43.6% with EMDR—far from a universal solution

5. Post-trauma therapy criticised for failing to address real-world trauma complexity

6. Newly qualified therapists experience burnout due to mismatch between training and client needs

4. Outdated MH Training and the Welfare Crisis

Let us connect everything written above. The unregulated and outdated mental health sector is partly responsible for the welfare crisis we now face. For example, many professionals still believe that people experiencing trauma or crisis recover in therapy rooms—primarily through talking, and especially through long-term therapeutic relationships. The public would probably be shocked to learn that many therapists don’t even know the difference between a crisis and a traumatic event. Nevertheless, academic institutions continue to train practitioners in outdated models, while academic research and clinical practice often exist in parallel worlds that rarely intersect. In reality, there is no solid evidence that isolated, long-term talking therapy is the most effective route to recovery for individuals who are traumatised or going through crisis (Part 3 will explore evidence further).

5. What is the way forward?

People recover through appropriate activity, connection, and community—not through weekly talking sessions with a counsellor or therapist, but by doing something practical. Crisis and traumatic events are, first and foremost, physiological experiences that activate or suppress the body’s survival responses. Recovery begins by re-engaging the body—not just the mind. Humans heal best in natural environments: family systems, workplace teams, civic roles, communities, etc. Recovery happens when people have the opportunity to contribute, connect, and feel part of something larger than themselves. These principles are central to what we call 4th and 5th‑Wave approaches to trauma care.

Real recovery begins not in prolonged introspection, but in restoring daily life. The rise in MH-based PIP claims signals both increased public distress and a professional model that’s failing to deliver what people actually need. It’s probably time to integrate the MH sector into other sectors and industries—and stop seeing people as self-sufficient individuals. We humans are social creatures who exist within systems—or communities—and we can only recover within these ecosystems.

Rather than isolating individuals in long-term therapy or diagnosis-driven models, we must support social engagement through manageable activities. This means children recover from crisis and trauma in school and families, not therapy rooms. So offering outdated training on child-focused intervention (“fixing a child”) does not solve MH issues. Instead, we should offer family-systems approaches, working with the environments children already inhabit. The same goes for adults: they exist within human systems and individual therapies without system-level integration fail over the long term, which is why outdated models promote many years of therapy.

Since most mental health professionals are not trained to address physical health or deliver body-focused interventions, we must be honest about the limitations of our role. In most cases, our contribution is secondary: we support people as they reconnect with their natural social environments—where true recovery happens.