No more waiting: Wales needs a mental health system that truly cares

James Downs

In Wales, people with mental health problems have long been caught in a system that delays the care they so desperately need. This isn’t just an administrative inconvenience; it’s a crisis with real- life consequences.

For years, people have been told to wait – for assessments, treatments, and a promise of change that seems ever elusive. Against this backdrop, the Welsh Government has now launched a new Mental Health and Wellbeing Strategy for Wales – the first significant overhaul in 12 years.

But the gulf between these aspirations and our current reality is stark. A report from Mind Cymru paints a very different picture in the here and now.

The mental health charity spoke to people across Wales with lived experiences of mental health problems while the new strategy was being drafted and found that, although the right support at the right time can be life changing, interminable waiting lists, a lack of empathy and disjointed pathways through care services are all too common.

Many reported being passed from one under-resourced service to another without
any continuity, leaving them feeling isolated and abandoned when they most needed support,
treatment, and compassion.

Behind the Statistics

Speaking from personal experience, I know how strategies and policies – which might sound
bureaucratic and boring – can have real-life consequences for people like me. Like many others who have navigated this system, I’ve spent years of my life waiting for any kind of treatment, despite serious illness and limited quality of life. Even after enduring seemingly never-ending waiting lists, there have been times when the only interventions I have received have felt dismissive, like token gestures, or like treatment that has done more harm than good.

The stories shared in Mind Cymru’s report resonate deeply with my own experiences. One
individual described appointments that felt designed solely to meet targets rather than address real, pressing needs.

A 17-year-old, rejected by services due to rigid age cut-offs, summed up the cruelty of the system by stating that they had no choice but to consider private care or unwanted medication because no other support was available. These accounts are not isolated incidents – they are the harsh reality for far too many people across Wales.

Ambitious

For years, mental health services in Wales have suffered from funding challenges and a workforce that is undertrained, overstretched, and under-appreciated. The system tends to treat symptoms in isolation, rather than understanding and addressing the complex, interconnected factors contributing to mental distress.

At present, access to care feels like a race to the bottom. I’ve often felt like you need to be the “right” amount of unwell at the “right” time, in the “right” body and identity, to even have a chance of getting treatment. This is not just unfair; it is a fundamental violation of patient rights.

This is not only harmful to individuals, it’s unsustainable for services, driving up costs further down the line as preventable crises escalate into emergencies. Too often, services are structured around these false choices: early intervention versus specialist care, child services versus adult services, crisis management versus long-term support. This creates gaps that leave many vulnerable people without the help they need.

Instead of forcing us into false binaries, we need a rights-based, holistic approach to mental health that recognises the full spectrum of human experience and ensures no one is left behind.

Vision

The new Mental Health Strategy for Wales offers a moment of hope – a chance to rethink and
rebuild. But hope alone is not enough. The people who feature in Mind Cymru’s research were clear.

Policymakers need to make sure that every person, regardless of age, location, or background, receives timely and high-quality support.

To achieve this, we must:

● Improve access to support: Every community in Wales deserves access to effective mental
health services. And promises of timely support mean little if help comes too late. Clear
benchmarks and transparent reporting must hold services accountable.

● Invest in our workforce: Mental health professionals are the backbone of the system. We
must invest in their training, support, and retention so they can deliver the compassionate
care every patient deserves. The system doesn’t just harm patients—it takes a toll on those
working within it, leading to burnout, moral injury, and an exodus of skilled staff.

● Improve quality of care: Access to treatment isn’t enough – the care on offer must also be
high quality, person-centred, and tailored to individual needs. Too often, support fails to
account for people’s differences and can feel like a one-size-fits-all approach. I’ve been given
interventions that didn’t reflect who I am or what I actually needed. Care should be
consistent, appropriately intense, and available for as long as it takes.

● Improve crisis care: Without early intervention or sustained support, many people only
get help when things reach breaking point. But even in crisis, care can be inadequate, and
sometimes, A&E is the only place to go. In my experience, this has often felt overwhelming
and unsafe, adding to my distress, and the staff haven’t always had the time to be
compassionate to me. Too many people are sent miles from home to find a bed, and others are left in chaotic wards with no real therapeutic help. It shouldn’t take a crisis to be seen, and even then, people deserve better.

● Better connect services: No one should have to navigate a fragmented system alone.
Integrated services, with clear pathways from crisis intervention to long-term support, are
essential in preventing people from falling through the cracks.

Lived experiences

A critical part of meaningful reform is ensuring that people with lived experience of mental health problems are more than simply quoted in reports, of course, but actively involved in creating the very system that is meant to serve us. Too often, decisions have been made about us, without us, and this has to change.

The future of mental health care in Wales needs to be built on the foundation of real, lived understanding of mental health problems. The work of Mind Cymru in seeking the views of people in Wales and feeding these back to the Welsh Government during the drafting process of its new Mental Health Strategy is not simply a critique, therefore, but a roadmap for change.

Trust

And Wales’ new Strategy for Mental Health is not just about designing a better system for the future, either. The pain of being misunderstood, misdiagnosed, and dismissed has lasting effects, eroding trust in services and leaving people without the help they needed, when they needed it most. Repairing the damage of the past is just as important to those of us who have had to manage alone, as preventing harm in the future.

Our new strategy for mental health must be more than a promise – it needs to truly perform for the people of Wales. The Welsh Government must act decisively and invest in a mental health system that can truly afford to care – where waiting is no longer the norm, where help is always within reach, and where every individual is valued for who they are at every stage of life.

This is not just a strategic shift; it is about restoring dignity, hope, and a sense of belonging to those who have been let down by a failing system. The time for bold, ambitious action to transform our approach to mental health in Wales is long overdue; but the second-best time is now.

James Downs is a mental health campaigner, researcher, psychological therapist and expert by experience in eating disorders.