As part of Mental Health Awareness Week 2026, we are interviewing Alistair Smith and Sarah Magson, personal injury solicitors at our Middlesbrough branch. They have been supporting the call for a public inquiry into the Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), which has now been confirmed, and they work with families from TEWV who have been affected by poor mental health care for their loved ones.
Q: Do you think mental health is still treated as “secondary” to physical health in policy and funding decisions?
Alistair: Yes, without doubt. Mental health provision has not kept pace with how radically society has changed, or with the wider impact of COVID-19.
Sarah: Yes, while there has been clear progress, mental health is still often treated as secondary to physical health in both policy and funding decisions. That said, increased awareness in recent years is a positive step, and it is vital that this continues so that mental health is given equal priority. By continuing to talk more openly, highlighting need, and demonstrating the very real benefits of effective mental health care and support, there is a genuine opportunity to drive further change and ensure parity with physical health going forward.
Q: Why is Mental Health Awareness Week important to you?
Alistair: It should be a time when we all reflect on both how our own mental health is and others that we know. A reflection and an acknowledgement that many may be experiencing their own difficult times.
Sarah: It is important because it raises awareness of mental health and creates space for open, honest conversations, helping people to better understand their own wellbeing and that of others. It encourages individuals to check in on themselves and those around them, while challenging stigma and building a more compassionate, supportive culture. For me, it is a valuable opportunity to highlight the importance of mental health, promote understanding, and reinforce that it should be viewed and prioritised in the same way as physical health.
Q: Tell us about the TEWV Inquiry and how this is progressing.
Alistair: Slowly, in short. We were told by Mr Streeting that they wanted a ‘Chair’ in place by the end of February. That has not happened and we are over 2 months further on. We need a chair for the inquiry to start work. Many people are understandably concerned about the pace of progress.
Sarah: Progress has been slow, which has been understandably frustrating for families, particularly given the urgency that was recognised at a much earlier stage. Whilst Mr Streeting confirmed back in March 2025 that an investigation was needed, and a Statutory Public Inquiry was eventually announced in December 2025, key steps such as the appointment of a Chair have still not been completed, meaning the Inquiry has not yet been able to fully commence. There have been some signs of movement, including the recent appointment of a Secretary, and assurances from the Government that the Inquiry will be thorough, hold individuals and organisations to account, and deliver meaningful, actionable change. Importantly, the establishment of a statutory inquiry itself is a significant and long‑overdue step, and offers a vital opportunity to ensure transparency, learning, and lasting improvement in mental health services.
Q: What can people do to support / find out more about the TEWV Inquiry?
Alistair: Please take a look at the Ison Harrison website for information and contact us directly by telephone 01642 070860 or via email to tewvinquiry@isonharrison.co.uk. There is a team dedicated to help. The DHSC has it’s own dedicated email address as well on tewvinquiry@dhsc.gov.uk.
Sarah: In addition to accessing information through Ison Harrison and contacting the dedicated team directly, people can also support the progress of the inquiry by contacting their local MP to raise concerns and maintain momentum at a national level. It is also helpful to sign up to Ison Harrison’s regular updates and newsletters to stay informed as matters develop. Importantly, those affected are encouraged to become involved at this early stage, as there will be opportunities to contribute to and help shape the Terms of Reference once a Chair is appointed, ensuring the inquiry reflects the issues that matter most to families and individuals.
Q: What are the most common issues faced by patients trying to access NHS mental health services?
Alistair: For many, the first hurdle is simply getting someone to listen and take them seriously – being heard without feeling dismissed, judged, or told to “come back if it gets worse.” After that, people often struggle to get timely action rather than what feels like a holding response or a “limited interim response” (a brief call, generic advice, or signposting that doesn’t lead anywhere). Long waiting times and high thresholds mean people can deteriorate while they are waiting, and it can be unclear who is responsible for follow-up in the meantime. Communication is another common problem: patients can feel they are repeating their story to different teams, not being kept updated, or not knowing what the next step is. Access can also be practical – appointments that don’t fit around work, caring responsibilities, transport, or digital access – especially when services are stretched. Finally, people often report that care isn’t sufficiently tailored to the individual: what helps one person won’t help another, and without being believed and understood, it’s hard to build trust or engage with treatment.
Sarah: Patients often describe feeling lost in the system, with many reporting that they struggle to be taken seriously at the outset and then face long waiting times during which their condition can deteriorate. There is frequently a lack of clarity about who is responsible for their care, with limited follow‑up and poor coordination between services, particularly across crisis, community and recovery pathways. Many feel there is insufficient specialist provision for more complex needs, and that services are not always tailored to the individual, which can undermine trust and engagement. Practical barriers also remain, particularly in rural areas and for children and young people, where local inpatient and specialist services can be limited, leaving patients uncertain where to turn for support.
Q: How does inequality (e.g., socioeconomic status, race, or geography) show up in access to mental health care?
Alistair: Inequality shows up at every stage. Some people – because of socioeconomic pressures, past experiences, or cultural factors – don’t feel able to challenge decisions or push for alternatives, so they accept what is offered (or accept being told there is nothing available). Others may question it, but not everyone has the confidence, time, transport, or support to keep chasing appointments, follow-ups, or a second opinion. Geography is also a major barrier: community services in rural areas can be limited, distances are greater, and public transport is often poor, which makes attending regular appointments much harder. Even when people do get into the system, care can feel inconsistent – different thresholds in different places, variable waiting times, and support that isn’t always tailored to the individual- so people can end up without the help they need at the point they need it most.
Sarah: Inequality is evident throughout the system, with those in more deprived circumstances often less able to navigate services, challenge decisions or persist in seeking support. Geographic factors also play a significant role, with more limited provision in rural areas and greater practical barriers to accessing care, including transport and availability of appointments. There is also variation in thresholds, waiting times and the availability of specialist services, meaning people’s experience of care can differ significantly depending on where they live. This can lead to individuals feeling overlooked, with gaps in multi‑agency working and follow‑up contributing to a loss of trust and a risk that those most vulnerable do not receive the timely and coordinated support they need.
Q: If you could implement one policy change tomorrow to improve mental health care, what would it be?
Alistair: More involvement of families – where it is appropriate and the person receiving care wants it. Families are often the people who notice early warning signs, hold important history, and provide day-to-day support, yet they can be left out of care planning and given very limited information. We need clearer guidance so confidentiality is handled properly but doesn’t become a default barrier to listening to families’ concerns. Practically, that means routinely offering family-inclusive appointments, making sure families know who to contact in a crisis, and involving them in discharge planning and ongoing safety plans. Better family engagement would improve continuity, reduce risk, and help ensure that care is coordinated around the real-life support network the person relies on.
Sarah: I would focus on strengthening and standardising crisis response services so that people can rely on a consistent, well‑resourced, and highly trained team being available when they need support most. Mental health crises benefit from timely, coordinated care, and improving the accessibility and clarity of services would help people feel more confident reaching out at the earliest opportunity. A responsive and well-supported crisis team, alongside appropriate involvement of families where this is helpful, can enhance early intervention, continuity of care, and overall safety.
In addition, expanding specialist provision for people with more complex needs would ensure that everyone receives tailored, longer-term support from experienced professionals, with an emphasis on building consistent and trusting relationships.
Finally, strong and independent oversight can play a positive role in promoting accountability, transparency, and shared learning—helping services continually improve and ensuring that high standards of care are maintained across the system.
Q: Are you optimistic about progress, or do you think change is happening too slowly?
Alistair: Change is happening too slowly. Am I optimistic? Yes – but I’m apprehensive. There is more awareness now, and more people are willing to speak openly about mental health, which matters. There are also individuals and teams across the NHS who genuinely want to improve things and work incredibly hard under pressure. My concern is whether there is enough appetite – both in government and within the system – for the kind of meaningful change that would be felt by patients and families on the ground. Too often, the gap between promises and delivery is explained away by capacity, budgets, and competing priorities, and the result is that people still face long waits, unclear pathways, and inconsistent support. I’ll feel more confident when we see clear accountability, proper resourcing, and measurable improvements – shorter waits, better continuity of care, and families being listened to – rather than another round of reviews that don’t translate into day-to-day change.
Sarah: Change is happening, but not at the pace that is needed, and delays in the TEWV Inquiry are a clear example of that. There is, however, a more positive shift in that mental health is being talked about more openly than ever before, and major inquiries, including TEWV and Essex, are bringing important issues into the spotlight. That increased visibility is crucial and can drive meaningful, long‑term change. There has to be continued focus on immediate improvements to safeguard those currently at risk, alongside longer‑term reform, but there is a genuine opportunity here. If the inquiry process is robust and gets to the root causes, it can deliver the systemic and cultural change that families have been calling for, and we must continue to build momentum and push forward.
