Mental health support is a growing priority area in the UK, with the NHS Long Term Plan setting out a vision for robust, 24/7, all age access to mental health crisis services. The access point for such a service is NHS 111.
When the NHS 111 #MentalHealth service launched across London in 2024, it promised to provide immediate support for people in crisis and offer an alternative to crowded emergency departments and long waits for care. The service in London is delivered by five NHS mental health trust providers, each covering distinct geographical areas and populations.
We have led an independent evaluation commissioned by NHS England in partnership with Health Innovation Network South London, which reveals how the service has performed and what needs to change.
A growing demand for help
Between April 2024 and February 2025, the service received more than 74,000 calls – an average of just over 6,700 per month. This showed that the service is in demand and meeting a clear need.
We worked closely with clinicians, commissioners, and people with lived experience to map services across five mental health trusts, analyse call volumes and referral patterns, gather staff and user feedback, and assess how well the service connects with wider health systems.
What users told us
Feedback from callers was encouraging, with 59% saying they would follow the advice given and 60% would use the service again. Many described feeling “relieved” and “listened to” during moments of distress. However, some found the experience impersonal, though this is based on feedback from 79 service users in total.
Staff echoed these concerns, highlighting the importance of detailed knowledge of local services and referral pathways. However, integration with physical health services, including the NHS 111 physical health service and telephone crisis lines, and data sharing remained difficult. In addition, recruitment challenges led to vacancies and staff highlighted both the rewarding yet emotionally demanding aspects of the role.
After NHS 111 #MentalHealth launched, fewer people were referred to primary and emergency care than the number of mental health–related calls that previously handled by the NHS 111 physical health service. Although the shift in referral patterns is promising, missing referral data from providers, inconsistencies between NHS 111 #MentalHealth and NHS 111 physical health datasets and the absence of actual attendances (a system-wide challenge) prevent a comprehensive understanding of referral pathway changes and the impact on Emergency Department demand.
What happens next
NHS England is using the findings to shape the next phase of development of NHS 111 #MentalHealth. Our recommendations include strengthening integration with NHS 111 physical health and out-of-hours services, improving communication and co-design with service users, and standardising training and care pathways. Data infrastructure will also be a priority to enable future economic evaluations.
As the service evolves, one thing is clear: the demand for mental health support isn’t going away. The challenge now is to ensure that when people reach out for help with their mental health, they find a system ready to respond consistently to their needs.
Find out more about this work, and read the full report, on Health Innovation Network South London’s website.