Bridging the gaps: The positive impact of third sector counselling services and the challenges they face

Public First was commissioned by BACP to conduct a piece of research on the state of third sector counselling services.

Many counselling services in England are neither part of the NHS nor in the private sector, but in the third sector: charities, social enterprises and other non-profit organisations. Some are commissioned to provide specific services by the NHS, or by other public sector bodies, and are accountable for delivering what they are paid to do. But they do more than just add additional capacity to the public sector: they add value too, with many providing additional services that are not funded by the taxpayer but nevertheless support people’s mental health, to everyone’s benefit.

Key findings:

Through our research, including interviews with representatives of third sector counselling services and others, we identified a number of sources of special value.

The diverse therapeutic approaches they offer, which in many cases go beyond what is available through the NHS.

Their ability to reach marginalised communities who may be reluctant to access mainstream services or who require specialist support which the NHS is unable to provide directly, although in many cases it may commission it from the third sector.

In the case of some specialist third sector services, their understanding of trauma which requires particular expertise and which can itself lead to a reluctance to engage with statutory services.

Linked to this, their independence from NHS structures, which provides them with a flexibility and freedom to innovate which is more difficult inside the NHS.

Their ability to provide their clients with longer-term counselling, in a more flexible way, than that which can be provided through NHS Talking Therapies.

The broader offer they provide alongside counselling, including stabilisation sessions before therapy, support with language and other skills, and social and wellbeing activities.

But we also found that third sector counselling services face significant challenges which threaten the viability of some services.

Services told us about how much work is involved in securing the funding they need from an extraordinarily wide range of sources, about being restricted to highly prescriptive short-term, and in some cases unreliable, contracts, and of being highly dependent on relationships with commissioners whose understanding of their value and expertise may vary.

At the same time, demand for the counselling services the third sector provides is rising not falling. That results in part from a greater awareness of and willingness to seek help for mental health problems, in part from increased pressure on people’s mental health arising from cost of living challenges in particular, and in part from an increase in referrals to third sector counselling from the NHS – many of which do not come with any funding attached.

Given this increase, third sector counselling services have adopted a range of strategies for managing demand, including cutting back on promoting their services and closing waiting lists. They have also had to find ways to support staff who are impacted by heavy workloads, and to try new ways of working.

Read the full report here