It’s Complicated is a platform that aims to simplify the search for a suitable therapist, but the search can be hindered also due to financial reasons. Many people, residents and expats included, simply aren’t fortunate enough to be able to pay privately for therapy in the United Kingdom. So how should you get therapy that is covered by the UK public health system?
How Therapy Works in the UK
Challenges
Therapy in the UK isn’t a smooth ride. The hurdles you may face might include:
- Long NHS wait times: The demand for mental health support is high, and NHS therapy often has very long waiting lists, often months long.
- Limited free sessions: The NHS typically offers short-term therapy (often 6–12 sessions), which might not be enough for deep-rooted issues, including trauma-related concerns.
- Finding the right fit: Not every therapist is right for every person. If you go through the NHS, you may not get much choice in who you work with and have to join yet another waitlist should you want to change practitioners.
- Limited choice of therapy type: Going through the public health care system limits you to only a few types of therapy. If group therapy or cognitive behavioural therapy does not work for you, you might still end up only being able to access these types since they’re the most readily available.
- Insurance Coverage Confusion: Private health insurance can help, but not all policies cover therapy.
Job Titles and Professions in the UK
Not all mental health professionals are the same. When looking for therapists in the UK, it’s good to know the difference between each:
- Psychological wellbeing practitioners are trained by the NHS to assess and support people with common mental health problems. They’re the practitioner type you would have encountered if you tried to access free mental health care.
- Therapists and counsellors provide talk therapy for emotional and psychological challenges. The range of accreditation of these practitioners vary as much as the type of therapy they give. All types of institutions (e.g. schools and universities) may have on-site therapists or counsellors to conduct sessions.
- Psychotherapist is another non-protected umbrella term in the UK. They work with clients to assess and treat a range of emotional, social or mental health issues.
- A psychologist is a mental health professional trained in psychological assessments and therapy. In the UK they must have at least a Master’s degree in psychology in order to practice.
- Psychiatrists are medical doctors who can diagnose mental illnesses and prescribe medication.
Be aware: Some professionals use the term ‘psychologist’ or other titles such as counsellor, psychotherapist or therapist. In the UK these are not protected titles, so professionals using them do not need to be associated with any particular mental health body or belong on a register such as the BACP.
How the Public Healthcare System Works in the UK
Wondering how to get therapy as an expat in the UK? The good news is that it’s usually free on the NHS. And the not-so-good news? Well, there are waiting lists.
Here’s how to get started:
- The first step in seeking mental health support is visiting a GP. The GP will assess the situation and decide on the best course of action. They may refer you to in-practice therapists or specialised care if necessary.
- The referral process varies by region:
- England: Most people are directed to the Improving Access to Psychological Therapies (IAPT) program, which offers psychological treatment for conditions like anxiety and depression. (Self-referral for IAPT services is possible. You can bypass the GP step if preferred.)
- Wales: A GP referral is required to access the Local Primary Mental Health Support Service.
- Scotland: GPs refer patients to the local NHS board, which determines the most suitable mental health service.
- Northern Ireland: Patients are referred to a regional Health and Social Care Trust for further assessment and care.
- Once referred, the mental health team evaluates the patient’s condition. This often involves completing forms that describe symptoms and severity.
- The type of therapy offered depends on the patient’s needs and local service availability. The most commonly provided therapy is cognitive behavioural therapy (CBT).
How to get Therapy covered by UK health insurance
Accessing therapists in the UK through private health insurance is another viable option, especially if you are seeking more immediate or specialised mental health support. Here’s how:
1. Review Your Insurance Policy
Examine your private health insurance policy to determine if mental health services are included. Coverage can vary significantly between providers and plans.
2. Understand Coverage Limits and Exclusions
Be aware of any limitations or exclusions within your policy:
- Session caps: Policies might limit the number of therapy sessions covered annually.
- Financial caps: A maximum monetary amount may be allocated for mental health services each year.
- Pre-existing conditions: Many insurers exclude coverage for mental health conditions that existed before the policy’s start date.
3. Obtain Necessary Referrals
Some insurance providers require a referral from your General Practitioner (GP) to access mental health services. This way, they can confirm that the treatment is medically necessary and facilitate the claims process.
4. Select an Approved Therapist
Insurance companies often have a network of approved therapists in the UK. Choosing one within this network is necessary for your sessions to be covered.
5. Initiate the Claims Process
After confirming coverage and selecting a therapist, some insurers require pre-authorisation from the insurer before commencing therapy. Make sure to keep detailed records of your therapy sessions and submit any required documentation promptly to your insurer.
6. Consider Out-of-Pocket Costs
Even with insurance, you may encounter out-of-pocket expenses:
- Excess Fees: The amount you agree to pay towards a claim before your insurance covers the rest.
- Co-Payments: Some policies require paying a percentage of each therapy session’s cost.
- Non-Covered Services: Services or treatments not covered by your policy.
Note: To receive NHS mental health support as a migrant in the UK, you must pay the Immigration Health Surcharge (IHS) as part of your visa application unless you qualify for an exemption.
How to Find Therapists in the UK
If the NHS route isn’t for you, there are plenty of ways how to get therapy as an expat in the UK:
- Online platforms – Online websites like It’s Complicated list accredited therapists.
- Doctor’s referral – Your GP may be able to recommend private or charity-based therapy options.
- Charities and nonprofits – Organisations like Mind, Rethink Mental Illness, and Samaritans provide support, including free or low-cost therapy in some cases.
- Private therapy – Private therapy means no waiting lists if you can afford it. Sessions typically cost £40–£100 per hour, but some therapists offer sliding scale fees based on income.
- Employee Assistance Programs (EAPs): Some companies offer therapy as a benefit. You could even request for your HR department to provide therapy for you and other employees at your company.
How It’s Complicated Helps You Find Therapists in the UK
We can connect you with a network of over 1,500 mental health professionals from 80+ countries – both online and in person. And with support available in nearly 100 languages, there’s help in a language that feels right for you.
Why Use It’s Complicated?
- No waiting lists – Get matched with a therapist quickly. No more months-long delays.
- Personalised matches – Find a therapist who fits your specific needs, preferences, and vibe.
- Online & flexible options – It doesn’t matter if you’re in London or a tiny village in Scotland; you can access therapy anywhere.
- Multilingual therapists – Great for expats or anyone more comfortable speaking their native language.
- Confidential & easy – No GP referrals, no paperwork, no stress.
In sum, while the easiest way to find a therapist that fits your needs is searching through a directory like It’s Complicated and going the private pay way, there are other options for getting great therapy in the UK. It might not be simple, it might not be ideal, but hopefully this guide can make your journey just slightly more manageable.
