‘Thanks, but no thanks’: The public's response to engagement with NHS Talking Therapies – a salutary tale?

Abstract Objectives The English NHS Talking Therapies has been hailed as a world leader in demonstrating outcomes, generating 1.76 million referrals in the year 2022–2023, with a claimed 49.9% recovery rate, but there has been a dearth of independent evaluations. Importantly, there have been no published data on those who only attended one assessment/treatment session. This also applies to public services internationally. The issue of the acceptability of psychological treatment has not been addressed. Method The user‐friendliness of NHS Talking Therapies was examined, drawing on unpublished data revealed following a Freedom Of Information request response to the author in June 2024. These data are set alongside the service's published data to give a more comprehensive view of real‐world outcomes and whether it should be a template for other countries to follow. Results Almost half (45%) do not complete treatment, and for completers, the results are no better than for placebo. The diagnostic status of almost a third (29.1%) who attend just one session is unknown. The numbers of people who attend one assessment/ treatment session is approximately half of those who attend two or more treatment sessions, but the ratio varies by disorder. Conclusion NHS Talking Therapies' engagement difficulties casts serious doubt on the service's claim to be a ‘world beater’. There is no evidence that NICE‐compliant evidence‐based psychological treatments have been delivered. While this model has been widely adopted in the UK, this should not be transferred to other service systems without contextualisation and evidence on whether/how some of its components could be implemented in those settings.