Another postcode lottery? Regional variation in NHS 111 services for mental health

In April last year, the NHS launched 24/7 mental health support through NHS 111. The service was publicly announced by the autumn and people were told they could ring 111, choose the newly added mental health option, and get connected to a mental health professional. The caller is connected to the mental health team that is geographically closest to them, as determined by mobile masts.

This is not a brand new service, as local health systems were operating their own version of these phone lines before the launch of 111 for mental health. There are also a host of free mental health helplines operated by different charities that offer a safe, non-judgemental space to talk.

The 111 service for mental health offers access to pre-existing helplines operated by local NHS mental health teams and some operated by a mix of private and charity providers that meet national minimum criteria in the way they deliver the service. This is beneficial because people can speak with a mental health professional on an easy-to-remember telephone number instead of hunting for a specific service during a time of crisis and disorientation.

In this blog, we explore what the data tells us so far about the NHS 111 mental health helpline.

The main 111 service sees a lot more traffic in terms of call volumes than the mental health service, presumably as it is a more established service that deals with a wider remit of problems. In 2024/25, the main 111 service received 1.6 million calls a month on average – roughly 12 times the number received by mental health services. After accounting for the fact that over time more teams have submitted data, volumes of calls for mental health 111 have stayed around the same range each month.

However, services differ starkly in their responsiveness. While 94% of calls received by the main 111 service were answered in 2024/25, only 69% of the calls received by the mental health service were answered. What’s more, three-quarters (75%) of the calls received by the main service were answered within a minute, compared to only 44% of the calls received by the mental health service.

Most calls that go unanswered are those that have been abandoned by the caller, i.e. disconnected before speaking to an operator (see data notes). Around 3% of the calls that came in to the main 111 line were abandoned by the caller, compared to 27% of the calls to the mental health line.

When looking across regions, the data on 111 for mental health varies significantly. To account for differences in size of region and measure of mental health need, we calculated the rate of calls received per 100,000 people in the needs-weighted population.

In 2024/25, the Midlands received the highest rate of calls at 4,390 per 100,000 population, followed by the North East and Yorkshire (3,026 per 100,000 population). London received the lowest rate of calls (664 per 100,000 population) – a sixth of the figure for the Midlands. The South West and South East had a relatively low rate of calls compared to the other regions (1,713 per 100,000 and 2,194 per 100,000 respectively). It’s hard to ascertain whether differences in volumes reflect differences in call statistics between local mental health teams which pre-dated the launch of 111.

There isn't a clear relationship between the number of calls received in a region and the calls attended to. The Midlands and North East and Yorkshire received the highest and second highest rate of calls respectively in 2024/25, but teams in each region only answered 70% of them. This compares to 84% of calls answered in London, the highest performing region for this metric and the one that received the lowest rate of calls. The South East and South West had some of the worst performances on responsiveness, with only 58% and 63% of calls answered in each region respectively.

As unanswered calls are those disconnected by the caller, it’s important to understand what is behind disengagement with the service. One of the factors could be the time taken to answer the call. While 60% of calls were answered in under a minute in London, every other region on average answered 41% of all calls in under a minute. For the South East, this dropped as low as 26% (data not shown).

Timeliness could in turn be influenced by the resourcing of local services. It is worth noting that there are multiple teams sitting within each region, but a larger number of teams within a region doesn’t necessarily correspond to faster service. For example, eight teams each operate in London and the South East (as of March this year). The two regions received relatively low rates of calls, but responsiveness in London was a lot higher than in the South East.

A national mental health helpline via 111 can help people by providing an empathetic listening ear and suitable signposting to other services. Existing data reveals that while responsiveness of the 111 service for mental health was already worse than the main service in 2024/25, there were also regional disparities in speed of provision, as the location of the caller had implications for how likely, and how quickly, their call would be picked up.

As the service beds in, it’s important that access equalises across regions. More granular data – allowing analysis of why calls are made, and their outcomes – would aid understanding of the impact of this new service and reduce the chances of inequalities going unnoticed and unattended.