Oct 7, 2026 · Comments ↓

The big mental health charities should be broken up

A 'UK' mental health programme sends its training through a body that only licenses England. It's a symptom. The money should follow local communities instead.

I don’t agree with large charities. I think the big mental health charities should be broken up into community ones, and the funding split across communities. This time it was a health company’s charity programme that set me off.

A UK programme with an England licence

Simplyhealth, the health plan company, runs a Mental Health Support Programme. The top of the page says “Improving access to mental health support in the UK”. Simplyhealth puts £1m a year into it, and the money goes to what Simplyhealth calls “three leading national mental health charities”: the Mental Health Foundation, MHFA England, and Mental Health Innovations, the charity behind the Shout text line.

MHFA England’s part is 2,600 funded training places for small businesses. When the partnership was announced in February, it was described as a £3 million, three-year programme to “expand access to proactive mental health support across UK workplaces and communities”. The programme FAQ says the courses are for “UK-based” small and medium-sized businesses.

Now read MHFA England’s own FAQ. Under “Why just MHFA England, why not MHFA UK?”, it says: “Each country licenses their own MHFA programme separately.” It then links to MHFA Scotland, MHFA Wales and MHFA Northern Ireland.

Mental Health First Aid International, which licenses the programme around the world, is clearer still. Its training page says: “As per our License Agreement, Mental Health First Aid Licensed Providers may only deliver MHFA courses in their country or territory and nowhere else.”

So a programme badged as UK-wide sends every funded place to the organisation licensed for England. The courses are online, and any UK-based small business can apply, so a business in Inverness could sign up. I haven’t seen anyone explain how that fits with a licence that stops at the border. And none of the places go through the bodies that license this work in Scotland, Wales or Northern Ireland.

I have a stake in this. I run a small social enterprise in Scotland that trains mental health first aiders. This isn’t about the quality of anyone’s courses. It’s about where the money goes, and how it keeps going to the same few places.

Big money finds big names

When a large company wants to give money to mental health, it usually partners with large charities. In my experience the employee assistance providers do the same. It’s the safe choice. The names are known, the logos look good together, the reporting is easy, and nobody gets asked why they picked a charity they’d never heard of.

The trouble is what that does over time. The big charities get bigger, their names get better known, and the next funder picks them for the same reasons. That starts to look a lot like a monopoly.

I’ve only ever worked for grassroots charities, so I know what competing with the big ones feels like. Small organisations struggle to stay visible, to be seen as important, and to stay part of their own communities. That’s sad, because the community is the whole point of them. Some of the best support I’ve had at work came from a building I shared with around 30 other charities, from people who knew each other and looked out for each other.

Scotland used to do this differently

We’ve done it another way before. Scotland had local associations for mental health, each one set up for its own area. The Glasgow Association for Mental Health has been helping people in Glasgow since 1978, and it’s still going. The Edinburgh Association for Mental Health became Health in Mind, which has been working in local communities since 1982.

Organisations like that knew their area and the people in it. That kind of knowledge doesn’t scale up, and it doesn’t survive having to compete with a national brand.

What it could look like

There’s a working model for this outside mental health. Buurtzorg, Dutch for “neighbourhood care”, was set up in 2006 by Jos de Blok and a few nurses who were fed up with how home care was being run. Teams of 10 to 12 nurses look after the people in one neighbourhood and manage their own work. It’s local, and it’s drawn international attention for delivering care at relatively low cost.

That’s what I’d want for mental health. Break the big charities up into community organisations. Split the funding pots across communities, so the money reaches the people who already know the area. When a programme says it’s for the UK, fund each nation’s own organisations and the local ones within them.

Large charities do some things small ones can’t. A 24/7 text line needs scale, and so does national research. I’m not arguing against those. I’m arguing against the habit of sending everything to the biggest names by default, because it drains the local organisations that people actually walk into.

Help works best when it’s close to the people who need it. The money should be there too.

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