3.9 million Londoners experienced mental health challenges last year, but over a third have never accessed support

• 69% of Londoners experiencing mental health challenges say they disrupt everyday life
• 45% of those struggling cite money worries as the leading pressure
• More than a third of those affected have never accessed support, exposing London’s mental health “missing middle”
• Hestia welcomes £187 million Government’s commitment to new community mental health centres.

New research reveals that more than half of adult Londoners (54%), equivalent to around 3.9 million people*, experienced mental health challenges over the past year.

Of those affected, more than two-thirds (69%) said their mental health negatively impacted their everyday lives, including their sleep, relationships and work.

Hestia’s London Mental Health Index 2026 is based on a representative YouGov survey of 2,081 London adults.

The findings come following the Government’s announcement of a £187 million funding for 100 new community mental health centres across England, offering walk-in support without a referral.

The missing middle

The report warns that too many Londoners are falling into a mental health “missing middle”: people whose difficulties are negatively affecting their work, education, relationships or other areas of daily life, but who have not accessed support.

More than half (57%) of Londoners whose mental health affected their everyday lives had not received support in the past year - an estimated 1.6 million people.

Among those identified in the research as the “missing middle”, 36% did not seek help because they felt their difficulties were not “serious enough”. Others were deterred by concerns about long waiting times (33%) or a lack of confidence that the available support would meet their needs (31%).

This suggests that simply investing more in early support isn’t enough on its own. The success of the government’s proposals will hinge on people being reassured that it’s okay to seek help early, as well as services being properly resourced so that support is available when people reach out.

Money worries driving poor mental health

Financial pressure was the leading factor affecting Londoners’ mental health. Almost half (45%) of those who experienced mental health challenges over the past year cited money worries, including debt, rent or mortgage payments and household bills.

Employment was also a significant factor. Almost a third (31%) said issues including redundancy, unemployment and difficulties at work had affected their mental health. Together, the findings reveal a clear link between financial security, employment and mental wellbeing.

The human impact of this financial pressure was clear in written comments. One anonymous survey respondent said:

“I have been unemployed for 13 months. I have had to borrow lots of money to keep up mortgage payments and renovate my flat so that it can be sold, because, even when I'm working, I can no longer afford the payments, bills etc. This has put a huge strain on my mental health, my friendships and my ability to see a good future for me. I do think that if I died, at least my will would pay off my debts.”

Other everyday pressures affecting Londoners’ mental health included loneliness or isolation (32%), feeling overwhelmed at work or in education (28%), and difficulties in personal relationships (27%).

Londoners want support closer to home

Londoners show a clear preference for mental health support in community settings over hospitals.

Two in five (40%) would choose services based in places such as GP surgeries, community centres or charities, compared with just 16% who would prefer hospital-based support.

Privacy was the most valued feature of those preferring community-based support, cited by 59%, followed by ease of access, and a calmer, less intimidating environment, all cited by 48%.

The findings support the Government’s plans to expand neighbourhood mental health provision and focus on prevention. However, for the Government’s proposals to work in practice, strong partnerships between the NHS and community organisations will be essential. Clear coordination, shared ways of working, and trusted local services can help ensure support feels accessible, joined‑up, and responsive when people need it most.

We need to go beyond clinical care alone, bringing together mental health support with practical help around work, income, and finances to support people’s recovery.

Monica*, who has received support from Hestia’s community-based mental health services, said:

“There will always be a place for the NHS and hospitals when people are in crisis … but mental health recovery doesn’t end after a few appointments or with a prescription. Ongoing support is essential. (When) I was struggling with my mental health and feeling extremely lonely, knowing I could drop in to Hestia Cove and speak to someone one-to-one if things became overwhelming was reassuring. But what made the biggest difference was being introduced to the weekly groups. I was around people who understood because they also had struggles. There was a sense of acceptance and support, Cove gave me a community.”

Recommendations

Hestia welcomes the Government’s investment in new community mental health centres. The charity is calling on the Government, Integrated Care Boards and local authorities to:

• Ensure that planned investment in accessible, community-based services incorporates support for the whole person, including sleep, relationships, physical health, work and overall wellbeing.
• Improve joined up working between hospitals, GPs, councils and voluntary and community organisations.
• Continue investing in services that combine mental health and employment support.
• Offer practical help with benefits, debt, housing and budgeting as part of mental health care.
• Strengthen public messages that normalise asking for help early.

Patrick Ryan, Chief Executive of Hestia, said:

“Millions of Londoners are experiencing mental health challenges, and too many are struggling silently without the support they need.

“We know from experience that poor mental health is often rooted in everyday realities such as financial strain, insecure housing, unemployment and loneliness. Clinical treatment remains essential, but it cannot address these pressures alone. People also need a safe place, someone to listen and practical support to help them move forward.

“We welcome the Government’s investment in new community mental health centres, which is an important step towards helping people earlier and closer to home. But this must be backed by sustained, long-term investment and strong partnerships between the NHS, local authorities and voluntary organisations.

Support should not begin only when someone reaches crisis point. We must ensure that these plans reach the Londoners who are currently without help, so that no one is left to struggle alone.”