The Fonagy Review: young people shouldn’t have to reach crisis point to get help

A young person shouldn’t need a diagnosis for their difficulties to be taken seriously. Nor should they have to reach crisis point before they can access support.

This is one of the key messages of the Fonagy Review, an independent review into mental health conditions, ADHD and autism in England, published last week. Its findings urge us to rethink how society responds to young people’s mental health needs.

The review confirms what Renew, alongside many other organisations working with children and young people, has recognised for some time: the rise in mental health difficulties is real. In 2024, one in four 16 to 24-year-olds met the criteria for a common mental disorder, compared with approximately one in six in 1993.

The review challenges the idea that young people have simply become less resilient and encourages us to consider the complex world they are growing up in and the pressures they face. It also makes clear that a formal diagnosis should not be a prerequisite for accessing support, recognising that young people can experience significant emotional distress without meeting the criteria for a diagnosed mental health condition.

At Renew, we have long championed the idea of going beyond labels and diagnoses to understand the individual in front of us. We believe that everyone’s experiences and circumstances are unique; meaningful support starts with understanding the person rather than simply the difficulties they are experiencing. It is therefore encouraging to see this approach reflected in the review’s recommendations for a more person-centred, needs-led system of support.

Support when it is needed – not just when it is critical 

A young person may be experiencing significant emotional distress without meeting the threshold for specialist mental health services. But why should we wait until their difficulties become more severe before offering help? Early intervention can help prevent problems from escalating, improving outcomes for young people and potentially reducing the need for more intensive support later.

Our early-intervention eating disorders service for young people, supported by the Prudence Trust and the Stone Family Foundation, is one example of this approach in practice. By offering counselling to young people experiencing early signs of difficulties around eating, body image and self-esteem, the service aims to provide support before problems become more entrenched.

In its response to the review, the Prudence Trust highlighted that effective community-based approaches already exist and that the priority now must be to strengthen and build upon them. We share this view. Specialist NHS care remains essential for those with more complex needs, but it must sit alongside accessible community-based support that can help young people before their difficulties escalate.

The opportunity for change 

The Fonagy Review makes a strong case for prevention, early intervention and the importance of support within local communities.

Organisations like Renew are already contributing to this work. But to ensure these services are accessible and sustainable, there must be meaningful investment and stronger collaboration between statutory services, schools and the voluntary sector.

The publication of this review presents an important opportunity. Its recommendations must not be welcomed and then forgotten. They need to be reflected in funding decisions, service planning and the way we measure success.

Improving mental health support should not focus on just reducing waiting lists or increasing access to diagnoses. A real improvement in England’s mental health support for young people would see more young people feeling better equipped to navigate their lives, maintain relationships, engage in education and look towards their futures with confidence.

We welcome the findings of the Fonagy Review. Now we must ensure its recommendations lead to meaningful action so that young people can access the support they need, when they need it.

What Frankie Taber’s Big Brother Moment Teaches Us About Listening

Saturday 10 October is World Mental Health Day and this year’s theme is “Lived experiences heard: real voices, real change”. At Renew, we know that finding the courage to speak about how your feeling is not a small thing. It’s the beginning of feeling less alone and discovering a way forward. 

Listening means being there, even before you know why 

We hear words all day. Listening asks more of us. It means setting aside assumptions and allowing another person’s experience to be true in its own right. 

When support comes before the explanation 

A recent moment on this year’s Big Brother showed why listening can matter so much. Housemate Frankie Taber became tearful while speaking with fellow housemates Pauline Adeyemo and Johanne Cade. They didn’t know the reason for his distress, but they stayed with him, listened and offered support rather than demanding an explanation. 

Later, in the Diary Room, Frankie shared that he had joined the programme intending to come out as bisexual. He spoke honestly about carrying guilt and shame, fearing that he had disappointed people and worrying about how those closest to him might respond. Big Brother reassured him that he had not let anyone down. 

What makes the moment so relevant to this year’s World Mental Health Day theme is that the listening came before the full story. Frankie didn’t have to explain everything before his feelings were treated as real. The people around him responded first to the person in front of them: someone who was struggling and needed patience and care. 

Why this year’s theme is so important

The theme reminds us that disclosure is not owed to anyone. Someone might need time before they can name what they are carrying or they may choose not to share it at all. It’s important that we still listen without judgement and show that support is available. When someone later feels safe enough to speak in their own words, being heard can loosen isolation and help replace shame with connection.

A place where your story can be heard 

It can be difficult to put an experience into words, especially if you’ve felt dismissed. Counselling offers a confidential space to explore what you are carrying, at your own pace, with someone trained to listen. 

We’re here for you, if you’re feeling unsure about where to turn or simply need someone to talk to. Please reach out. You don’t need a referral – we are an open access service and have a range of counsellors to suit your needs.   

You can click here to contact your closest centre. 

Results Day: It’s Okay to Feel Nervous 

It’s results day tomorrow and if you’re reading this while waiting for your results, I know there may be a lot of emotions running through your mind. But before anything else, congratulations. Getting to this point has taken so much hard work and resilience, and that deserves to be recognised. Whatever you’re feeling is completely normal.  Feeling nervous does not mean you aren’t ready, it just means you care. 

The night before results day 

This time last year, I was waiting to receive my A-Level results and I remember feeling every emotion. I kept trying to find things to distract myself because sitting with the “what ifs” felt difficult. I had chosen a different route to a majority of my friends, which I feel added an extra layer of uncertainty.  

Looking back, I wish I reminded myself that nerves are not something to be ashamed of. It’s a big day and it makes sense to feel emotional about it. You are allowed to care and you are allowed to feel unsure.  

What to do before results day 

The day before results day, try to be gentle with yourself. Whatever is in that envelope has already been decided, so overthinking every possible outcome really isn’t worth it. Do something that helps you feel calm or distracted, for me that was going for a walk and seeing my friend but maybe for you that could be watching a comfort show, getting an early night or spending some time with your family.   

Preparing things the day before can also help. You can do this by:  

• Making sure your phone is charged 

• Checking how and when you will receive your results 

• Having any important details ready if you need them.  

• If you’re applying to university, keep your UCAS information close by.  

• If you are considering other routes, make a short list of people or services you can speak to for advice. 

On results day 

When the moment arrives, take a breath. You don’t have to open your results immediately. You also don’t have to react in the same way as everyone around you. Some people cry or laugh and others may go quiet and take some time to let it all sink in. However you respond, it is okay. 

If your results are what you hoped for, celebrate them. Be proud and allow yourself to enjoy the moment. If they aren’t what you were expecting, try not to panic. Speak to a teacher, parent, carer, careers adviser, college, university or someone you trust before making any big decisions. There are always next steps, even if they are not the steps you first imagined. 

After you receive your results 

Once you have your results, give yourself time to process them. Results day can feel like everything has to be decided straight away but many next steps can be talked through with support. Depending on your plans, you may want to look into university options, Clearing for example, or a completely different route. 

One thing I’ve learnt is that there is no single “right” path. Choosing a different route from my friends was definitely scary, but it also led me to something that’s much better suited to me.  

A reminder for anyone feeling nervous 

If you are anxious about results day, please know that you are not alone. It is okay to feel nervous. It is okay to feel proud and scared at the same time. And it’s most certainly okay if your journey looks different from someone else’s. 

Whatever happens, take a moment to recognise how far you have come. You showed up and made it to this point. That deserves to be acknowledged. Congratulations on receiving your results.  

Need someone to talk to after Results Day?  

We’re here for you, if you’re feeling unsure about where to turn or simply need someone to talk to. Please reach out. You don’t need a referral – we are an open access service and have a range of counsellors to suit your needs.    

You can click here to contact your closest centre. 

Renew’s Graduate Celebration Day 2026 – In conversation with our special guest, Mamood Ahmad. 

We’re delighted to be marking the graduation of our Diploma and BA students with a Celebration Day this week, where we’ll be honouring the achievements of our graduates and hearing from exciting speakers.

As part of our celebrations, we’ll be joined by therapist, lecturer and founder of The Anti-Discrimination Focus (#TADF) community, Mamood Ahmad, who will be delivering a guest lecture on “Harm Consciousness as an Antidote to Harm”, also discussing his most recent publication “A New Introduction to Counselling and Psychotherapy: Embedding Context, Diversity, and Equity into Practice”.

We caught up with Mamood for this week’s Renew Blog – read on to find out more about his journey.

Thanks for joining us, Mamood!  Could you share what first drew you to psychotherapy and mental health work?

I became interested in this work as a client. I went to therapy at a crossroads in my life, when I needed to make important decisions and work through feelings associated with childhood, family, and societal harm and neglect, as well as confront my own contribution to harm. I also had to make decisions about boundaries in relationships, as well as what justice means.

Through this process, I worked with a male CBT therapist whose openness, appropriate self-disclosure, and honesty impressed me and demonstrated the value of therapy done well. At the same time, I was looking for a career change from IT, and I became passionate about the healing potential and agency that therapy can offer. The rest, as they say, is history.

You founded The Antidiscrimination Focus. What led you to create TADF, and what need were you hoping it would meet within the therapeutic profession?

I launched The Anti-Discrimination Focus (#TADF) as a community collaboration aimed at improving the initial standards of counselling and psychotherapy education in the UK. Despite long-standing recognition by academics and advocacy-oriented therapists, pressing concerns remained: issues of context, including social contexts, identity, culture, diversity, neurodivergence, embodiment, social justice and equity, had not sufficiently permeated initial training programmes. Furthermore, these elements were also not typically embedded in the foundational pillars of self-development and theory risking fragmentation and gaps in knowledge. The community was created to influence the culture of the profession and to develop a cost-effective solution to the problem. Without this, there is an increased risk of inadvertent harm to all clients and students, as well as increased tutor stress, particularly for those who are more vulnerable, marginalised, underrepresented or underserved.

Note: #TADF are looking for more advocates to join them. If you are interested please email newintro@tadf.co.uk

Where do you think the profession has made meaningful progress, and where do you feel there is still more work to do?

Over the past five years, there has been a growing number of therapists and students who are increasingly contextually aware, including in relation to the systems within the profession itself. More critical debates are now taking place about its future, particularly around access, cost, harm, marginalised communities, and the potential exploitation of therapists, for example through reliance on volunteers or low-cost labour while those in leadership or brokerage roles receive the financial benefits.

There are multiple strands that still need to progress, including fair pay, equitable access, debates about qualification hierarchies, and concerns about decontextualised practice, all of which can act as collective barriers to fairness in therapeutic services. We remain in a fragmented position where “context, difference, and EDI” are often treated as secondary considerations rather than being embedded across the curriculum as core elements of all training.

My aim is therefore to raise awareness through the curriculum and explore how this might catalyse broader progress across these areas. Up until now we haven’t had in my opinion, an accessible low-cost solution to progress this.

You’ll be delivering a session focused on your most recent publication, A New Introduction to Counselling and Psychotherapy: Embedding Context, Diversity, and Equity into Practice. What inspired you to write this book?

I was at a crossroads with #TADF community, as progress was slow and blocked for a number of years. It failed to generate large-scale interest among training providers. Considering other options, I revisited the idea I had in 2020 of creating a new format for introducing a counselling and psychotherapy book but was reluctant to pursue it due to the significant personal and familial energy it would require. Introductory books on counselling and psychotherapy shape the field’s foundational culture, and writing a new one could catalyse change at individual, training institute, and thus systemic levels. By mirroring the desired curriculum changes outlined in this book, it serves therapists, training providers, and standards bodies. It took two years to write, and so far, I am glad the work is paying off, with over twenty tutor advocates using the approach in training organisations and many more advocating for it, as well as several organisations fully adopting the model, the book, and its pedagogical approach. But there is still a huge amount of work to do.

The book introduces the importance of seeing the “client in context” and taking a whole-person approach. What does that mean in practical terms for therapists and trainees?

Although a person’s experience is centralised, it means taking account of the context within which experiences are formed. The wholeness solution recognises the dynamic interplay between inner, interpersonal, and contextual factors* in shaping experience, as well as how these dynamics are expressed in relationships and reflected in evolving curriculum, training, and practice.

The difference in my approach is that context is not separated out; it is part of the client’s whole experience (e.g., worldviews, home culture, diversity). I explicitly provide practical tools and skills for considering context in practice, rather than treating it as a vague or ambiguous concept. For example, contextual (WICKET) is defined as the intersection of worldviews, identities, lived contexts and cultures (individual, personal, structural, and sociocultural), embodiment (patterns and experiences), and time (e.g., intergenerational), which may be socially normative or different.

Why is accessible counselling, particularly in terms of cost, important?

Who has access to counselling and mental health services is a vital question of equity. There can be many barriers to access, such as cost, language, neurodiversity, childcare, and the availability of therapists who are proficient in working with clients’ whole lived experience. Traditionally, therapy has originated from normative middle-class assumptions rather than fully engaging with the richness of lived experience across different contexts, including the knowledge and ways of knowing that clients bring. Without equitable access, the poorest, most vulnerable, different and most marginalised in society will be overlooked impacting mortality and quality of life.

What do you hope participants will take away from your session with Renew?

I hope participants will develop a deeper awareness of harm and how we might bridge and repair divides, along with its impact on themselves, clients, groups, the planet, and the wider world.  I hope that the term Relational Scope (as well as contextual empathy, pre-rupture, pre-empathy) will stick and become part of how we question who is afforded empathy and who may be dehumanised, and that it will be applied to self-development. It invites the question: how far can my empathy extend? And we do not pathologise, especially difference, or inadvertently convert people’s identities or beliefs to societal norms but instead support, affirm, and give agency to clients.

What advice would you give to someone at the beginning of their counselling or psychotherapy career?

Give yourself time to grow and access the opportunities you need. It often takes 3–9 months to start getting clients, and it can be helpful to use this “quiet” period to plan ahead so you do not feel dependent on narrow marketing options or as though you are putting all your eggs in one basket, for example, using social media, networking, or applications to counselling organisations.

Depending on the context and time elapsed, if you find that people are not drawn to your profile, or that clients are not staying for more than a couple of sessions, it may be an indicator to seek feedback. Seeking honest feedback from people who can be direct is often more useful than feedback that is simply supportive of your efforts. I remember doing this myself and I make sure I tell others about this possibility. We should all remain open to learning and maintain a beginner’s mind, regardless of our level of experience.

It is also important to remember that, although the market is changing, for example, with the rise of AI, and pay through brokers can feel as though it minimises your investment, there are many settings and organisations where your services will be needed, as well as the possibility of diverse portfolio working if you choose. Although I do not believe a niche is essential, it can be useful for advocacy, meaning making and increasing visibility. For example, if you are working with domestic abuse, you might write articles or deliver training on the topic, become more widely recognised in that area, and gain access to opportunities within specialist domestic abuse counselling organisations.

Want to know more about training with us?

Whether you’re a Renew graduate just starting out in practice or you are many years into the work, Mamood’s words are a reminder to stay curious, question assumptions and keep people at the centre of our practice. 

We’re so looking forward to welcoming him to our Celebration Day and to sharing the moment with our brilliant community of trainees, graduates and tutors.

If you’d like to find out more about training with Renew, please get in touch with Georgie Markwell and the training team via georgiemarkwell@renew.org.uk or 01245 264348.