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(PART 1) - System Failure: Why Mental Health Sector Fails the Public (Originally published on LinkedIn)

Updated: Jul 1

Across the UK and EU, the mental health sector is quietly facing a systemic crisis. This crisis isn't just about underfunding or long waiting lists (this is what the public usually hear). It's rooted in outdated training models, the lack of enforceable professional regulation, and a dangerous spread of ineffective interventions in settings where psychological support is urgently needed.


1. Universities Are Failing the Moment

Most universities across Europe continue to offer psychology and psychotherapy programmes designed around traditional talk therapy models. These curricula often lack any depth in trauma-specific approaches, crisis response protocols, or nervous‑system‑based stabilisation interventions. Graduates leave with academic qualifications but without practical tools to support people in acute distress, particularly in the early days or weeks after trauma.


The education and academic system has not kept pace with real-world problems. Much of it is driven by internal politics and ideological activism, trapped in an artificially created cocoon of knowledge dissemination. In practice, this means that as long as an academic paper gets published, it is treated as valid — regardless of its real-world relevance. As a result, entire fields are now built on theoretical arguments that are disconnected from frontline clinical realities. It’s possible to argue almost anything today and support it with citations, while missing the point entirely: much of this research has lost any connection to actual clinicians and the people they serve. For those working in real crises, this makes academic output not only unhelpful, but often meaningless. This growing disconnect has pushed education even further away from modern understandings of trauma, the body, neurobiology, and the systemic nature of crises.


📌 Supporting Evidence:

👉 The Future of Higher Education: Identifying Current Challenges – MDPI Confirms that higher education is failing to align with real-world problems, noting a critical gap between academic content and practical application, especially in health and social fields. https://www.mdpi.com/2227-7102/12/12/888

👉 Psychologists’ Response to Crises: International Perspectives – ResearchGate Reveals that psychology programmes across universities offer little to no training in crisis intervention or trauma-specific care, leaving graduates unprepared for real-world crises: https://www.researchgate.net/publication/258189077_Psychologists%27_response_to_crises_International_perspectives

👉 Disaster Mental Health in Higher Education: A Review – Journal of Emergency Management Highlights that disaster and trauma-related mental health training is neither standardised nor prioritised in university programmes, contributing to professional unpreparedness. https://wmpllc.org/ojs/index.php/jem/article/view/2420


2. The Illusion of Regulation — and Endless Dialogue Masks a Resistance to Real Accountability

Counsellors and psychotherapists in the UK and most of the EU are not statutorily regulated (apart from psychologists and a small number of other professionals). For example, registration with bodies like BACP or UKCP is voluntary — meaning anyone can call themselves a counsellor or psychotherapist.


As a result, most accredited courses still teach models developed decades ago, often without questioning their applicability to real-world challenges or the actual needs of the public. This self-regulation model leads to enormous variation in training quality and offers no legal protection for those seeking support.

It also enables people with only basic training — or even a short online course — to describe themselves as “trauma-informed.” The result? A deeply misleading and sometimes harmful therapeutic landscape that leaves the public vulnerable and confused.


📌 Supporting Evidence:

3. Outdated or Harmful Interventions Are Widespread

The mental health sector's lack of guidance and modernisation has allowed outdated crisis interventions to flourish across industries. These include:


3.1 Emergency Services (Police, Fire, Ambulance, Military)

Many services still rely on Debriefings, CISM/CISD models—shown to be ineffective and even retraumatising. Others use TRiM ("better than nothing"), but lack solid evidence of effectiveness.


📌 Debriefing Harm Evidence:

👉 PubMed review on PTSD prevention failure: https://pubmed.ncbi.nlm.nih.gov/12076399/


3.2 Aviation & Transport

There is no consistent, mandated psychological support framework for passengers or staff after aviation incidents—be they crashes, near-misses, or onboard emergencies. Each airline operates in isolation, offering ad-hoc responses without oversight from regulators, who prioritise aeromedical fitness and physical safety while neglecting psychological crisis care.


📌 Supporting Evidence:

👉 EASA MESAFE Project – Acknowledges importance of mental fitness but lacks mandated post-incident trauma care protocols: https://www.easa.europa.eu/sites/default/files/dfu/mesafe_-_d-5.1_d-6.1_reports.pdf

👉 Aviation Week – Peer support encouraged, but UK Civil Aviation Authority (CAA) does not require crisis-specific psychological response: https://aviationweek.com/air-transport/europes-flight-crew-mental-health-rules-take-effect


3.3 Education Sector

UK schools do not have statutory trauma-response or emotional-stabilisation protocols, despite frequent exposure to events like bereavement, bullying crises, or community trauma. Staff rely on general pastoral systems rather than specialist trauma-informed interventions.


📌 Supporting Evidence:

👉 Making schools trauma-informed – Centre for Mental Health This briefing highlights the lack of statutory obligation for UK schools to adopt trauma-informed or emotional‑stabilisation frameworks, instead relying on general pastoral systems. https://www.centreformentalhealth.org.uk/wp-content/uploads/2020/01/Briefing_54_traumainformed-schools_0.pdf

👉 A Systematic Review of Trauma-Informed Approaches in Schools – PMC Highlights that trauma-informed models in UK schools are rare and lack consistency: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357891/

👉 Developing trauma-informed teacher education in England – London Review of Education, UCL Press Explains that trauma-informed practice is not systematically included in UK teacher education: https://journals.uclpress.co.uk/lre/article/pubid/LRE-21-29/


3.4 NGOs & Humanitarian Organisations

Even in high-trauma settings, NGO and humanitarian staff usually get minimal psychological support, often limited to outdated CISM-style debriefings that evidence suggests may be ineffective or harmful. Their levels of vicarious trauma and psychological distress are significantly higher than other emergency professionals.


📌 Supporting Evidence:

👉 France 24 – Aid workers suffer from trauma, burnout, and lack of mental health support: https://www.france24.com/en/20180513-mental-health-struggles-humanitarian-sector-ngos-ptsd-msf-unchr-oxfam

👉 ResearchGate – CISM study – Highlights CISM’s limited or negative effectiveness: https://www.researchgate.net/publication/10790723_Critical_Incident_Stress_Management_CISM_Benefit_or_risk_for_emergency_services

👉 Vicarious trauma in humanitarian settings: https://www.tandfonline.com/doi/full/10.1080/23761407.2018.1466375


3.5 Workplaces

While UK employers have general duties under mental health legislation, there are no specific legal requirements for trauma response protocols when incidents like on-site deaths, violence, or public emergencies occur. As a result, organisations are often left scrambling—reacting inconsistently and without trauma-informed guidance. General mental health policies exist, but trauma-specific frameworks are largely absent.

Expecting current systems to manage modern workplace trauma is like asking people to live 500 years in the future while still driving cars from today — outdated tools, unfit for the world they’re now navigating.


📌 Supporting Evidence:


🏥 3.6 Healthcare (Hospitals & Clinics)

There is no legal requirement in the UK for trauma-focused psychological interventions in healthcare settings following critical incidents (e.g., patient deaths, pandemics, violent events). As a result, implementation is inconsistent and under-resourced — leaving staff to manage without adequate training or trauma-specific support. While some hospitals provide peer‑support systems or Employee Assistance Programmes (EAPs), these are often sourced from therapists or coaches without appropriate crisis or trauma response training.


📌 Supporting Evidence:

👉 NHS England – Patient Safety Incident Response Framework (PSIRF) This national framework addresses systems learning after incidents, but does not require psychological trauma interventions for staff. 🔗 https://www.england.nhs.uk/patient-safety/incident-response-framework/

👉 EU report on mental health at work states psychosocial risk regulations are insufficient, and consistent enforcement is lacking across member states: https://www.europarl.europa.eu/RegData/etudes/STUD/2023/740078/IPOL_STU(2023)740078_EN.pdf

👉 ECB tender document outlines “crisis intervention and trauma counselling services” as optional provisions, not mandatory healthcare protocols: https://www.ecb.europa.eu/ecb/jobsproc/proc/pdf/can_pro-006474_2022-ojs161-457854-en.pdf

👉  EU expert panel highlights urgent need for frameworks addressing psychological distress among health workforces—but notes no mandated crisis-response measures exist: https://health.ec.europa.eu/system/files/2021-10/028_mental-health_workforce_en_0.pdf


We Need a Rethink

We need urgent reform to:


  • Modernise university training, embedding trauma, stabilisation, and community-based care models.

  • Enforce real regulation for those working with crisis & traumatised populations.

  • End the use of harmful interventions and implement evidence-based, practical models like Psychological First Aid (PFA) and structured stabilisation that are part of step recovery model

  • Support industries with up-to-date frameworks tailored to their crisis risks.


The Complex Trauma Institute believes it is time to bring professionals, policymakers, and institutions together to create safer, trauma-informed systems. Follow us to be part of this essential conversation. https://www.complextraumainstitute.org 



Get in touch if you’d like to learn more or Check out our upcoming workshops:

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