Every year, thousands of people with mental health conditions in the UK are missing out on cutting-edge treatments because the NHS is losing ground to private companies in clinical research, a new study from The University of Manchester has warned.
Over the past five years, NHS recruitment into commercial clinical trials has collapsed by 44%. In that time, private contract research organisations (CROs) have surged ahead, offering dedicated facilities, slicker operations, and higher payments to participants. Pharmaceutical companies are now choosing these private firms over the NHS and universities to run early-stage mental health trials.
The study, published in the journal Brain, asked both pharmaceutical executives and patients who had taken part in mental health trials for their views.
Patients said they were driven to take part by the chance of closer medical monitoring, early access to promising new medicines, and the hope of improving services for others. But many reported frustrations with NHS-led studies - including lack of communication, no updates after the trial ended, and confusion over how their data was used.
Crucially, money makes a difference. CROs typically offer far more generous reimbursements than the NHS, making trial participation more appealing. The researchers argue that if the NHS is serious about competing, it must review how it compensates patients.
"The NHS has world-class expertise and access to diverse patient groups, but without new investment and streamlined systems, we risk missing out on breakthroughs in mental health treatments," said Dr Aiste Adomaviciene, lead researcher from Manchester's Division of Psychology and Mental Health.
The report calls for urgent reforms, including:
Faster approvals - cutting the red tape that slows NHS trial delivery.
Flexible design - letting participants choose between home visits, clinic appointments or online check-ins.
Specialist centres - building dedicated hubs for mental health trials inside major NHS Trusts.
Smarter promotion - using social media campaigns and testimonials to boost awareness and trust.
Despite the surge of private providers, the NHS still has key advantages. It can draw on huge, reliable patient datasets and long-standing doctor-patient relationships that private firms cannot match. This helps ensure trials include a diverse mix of people - and prevents the problem of "professional patients," which industry leaders say can account for up to 30% of participants in US depression trials.
The study was supported by the UK Government's Office for Life Sciences and the National Institute for Health and Care Research.
