Free and low-cost therapy in the UK: your options and how to self-refer
If you are struggling and worried about the cost of help, you are not alone. Many people in the UK want support but feel unsure where to start, what is free, and how long they might wait. Taking the first step can feel daunting, especially if you are already exhausted or overwhelmed.
This guide explains the main free and low-cost routes to therapy in the UK, how self-referral works, what to expect at assessment, and where private therapy can complement NHS care. You will also find local signposts for Richmond, Twickenham and Southwest London, plus UK-wide online options.
What is free on the NHS right now
NHS Talking Therapies (previously known as IAPT) offer evidence-based help for common mental health difficulties such as anxiety, depression, panic, phobias, health anxiety, OCD, and postnatal concerns. Support ranges from guided self-help and workshops to one-to-one Cognitive Behavioural Therapy (CBT) and counselling for depression. Services are available to adults registered with a GP in England. Similar services operate in Scotland, Wales and Northern Ireland under their national health systems.
You do not need a GP referral to use NHS Talking Therapies, and there is no charge. Waiting times vary by area and by need. Many people start with an online form, then have a short triage call before assessment. If your difficulties are more complex or there is risk involved, NHS teams can discuss other NHS pathways with you.
You can also access free mental health support through your GP practice. GPs can offer brief support, consider medication, and refer to local services. Some practices have in-house mental health practitioners.
How self-referral to NHS Talking Therapies works
Most areas have a dedicated self-referral page. The process typically looks like this:
Find your local NHS Talking Therapies service by searching NHS Talking Therapies plus your borough, or use the NHS service finder.
Complete a short online form with your contact details, GP, and a few screening questions.
Take a brief telephone triage call to confirm your information and immediate needs.
Attend an assessment appointment, usually by phone or video, to discuss your goals, history, risk and preferences.
Start with the most suitable option offered, which might be guided self-help, a group course, or one-to-one therapy.
Tip: if forms are difficult right now, you can usually call the service directly to self-refer by phone.
What to expect at assessment
An assessment is a conversation to understand what is going on for you and what would help. You may be asked about:
Current symptoms, triggers and how they affect daily life
Past support or therapy and any medication
Risk and safety, including suicidal thoughts or self-harm
Preferences for format, such as online, group, or one-to-one
It is normal to feel nervous. You can pause, ask for clarification, and say what matters most to you. The assessor will explain recommended options and next steps, including any waiting time.
Free and low-cost options beyond NHS Talking Therapies
If NHS routes are not the right fit, there are other places to find support:
Charities and community organisations. Mind, Rethink Mental Illness and local wellbeing hubs often provide free groups, helplines and low-cost counselling. Availability and eligibility vary.
University and workplace support. Most universities offer student counselling. Many workplaces have an Employee Assistance Programme (EAP) that includes short-term counselling.
Faith and community counselling services. Some offer donation-based or low-fee sessions.
Crisis support. If you are in immediate distress, call 999 or go to A&E. For urgent mental health help that is not life-threatening, contact your local NHS urgent mental health helpline. Samaritans are available 24 hours on 116 123.
Costs outside the NHS can vary. If a service advertises sliding-scale fees, ask about current availability and how long reduced-fee spaces tend to remain open.
Who is entitled to free therapy in the UK
In England, any adult registered with a GP can access NHS Talking Therapies at no cost. Entitlement is based on clinical need, not income. Other services may have specific criteria, such as student status for university counselling or local residency for certain charities. If in doubt, ask the service directly.
Balancing NHS and private therapy
Sometimes the best route is a blend. For example, you might:
Join an NHS CBT group to learn practical tools, then use private sessions for deeper, relational work at your own pace.
Begin private therapy while on an NHS waiting list, then decide whether to continue privately once NHS sessions start.
Choose private therapy if you prefer a consistent weekly slot, longer-term depth work, or a specific modality that is not offered locally.
At EPJ Therapy, I offer an integrative approach that can sit alongside or follow NHS support. We can focus on short-term skills or explore longer-term themes such as self-worth, patterns in relationships, grief and life transitions. If you are looking for a therapist for face-to-face sessions, or secure online therapy across the UK, we can clarify what would suit you in a brief call.
Making local options work for you
Where you live, your schedule, and how you prefer to meet can all shape what feels possible right now. Some people like to keep everything close to home, others find that online support gives them more flexibility and privacy. You might combine a local NHS or charity service with online sessions so that you have options if your circumstances change.
If geography or travel are barriers, it can help to:
Ask any service you contact whether they offer phone or video appointments
Check if there are nearby community hubs or wellbeing centres linked to local mental health support
Consider whether evening, early morning, or lunchtime sessions would make it easier to attend
Giving yourself permission to choose what is practical as well as meaningful can make it more likely you will be able to stay with support long enough for it to help.
A gentle next step
You deserve support that fits your needs and your life. Whether you start with NHS Talking Therapies, a community service, or private sessions, there is a path forward. If you would like personal guidance, you are welcome to book a free introductory therapy call to talk through options for short-term skills work or longer-term integrative psychotherapy, in person or online across the UK.
If now is not the right time to reach out, you might begin by bookmarking a few of the services mentioned here, noting down helpline numbers you may want to use in a crisis, or talking to someone you trust about how you are feeling. Taking even a small step to acknowledge that you deserve support can be a powerful start.