Private Mental Health Assessment in London 2026. When a GP Is Enough, When You Need a Psychiatrist and What Cannot Be Prescribed at a First Visit

Reviewed by the medical team at The Wellness. Last updated 1 September 2026.

Ask which assessment is right for you or email team@thewellnesslondon.com or call 020 3951 3429.

When a GP assessment is enough

For most anxiety, low mood, stress, panic, sleep disturbance and the first months after a loss or a life event, a GP is the right doctor and the assessment is the treatment's first step. The consultation scores a PHQ-9 for depression and a GAD-7 for anxiety, both validated by Kroenke and Spitzer with sensitivity and specificity around 88% for their target conditions, asks the risk questions directly, takes a history of sleep, alcohol, drugs, work and relationships, and checks the physical causes that mimic mental illness, including thyroid disease, anaemia, vitamin B12 and D deficiency and sleep apnoea.

NICE guideline NG222 sets out the pathway. For less severe depression the first offer is a psychological therapy, and the NHS Talking Therapies service in England can be self-referred to online today without a GP, with a target that 75% of people start treatment within 6 weeks. For more severe depression or where therapy alone is not enough, a GP can start first-line medication, review it at 2 to 4 weeks and continue for at least 6 months after recovery. Most people never need more than that, and the assessment says so when it is true.

When you need a psychiatrist

A psychiatrist is a doctor who has specialised in mental illness for a further 6 years or more, and some conditions a GP should not diagnose or manage alone. Suspected ADHD in an adult, because the assessment takes hours, needs a developmental history and rating scales from a second informant, and the medication is a controlled drug that needs specialist initiation and titration. Suspected bipolar disorder, because an antidepressant given alone can trigger mania. Any psychotic symptom. An eating disorder with physical compromise. Depression or anxiety that has not responded to 2 adequate treatments.

The psychiatrist consultation here is separate from the GP and lasts around 60 minutes, and it is arranged with the referral made and the appointment booked rather than left as a recommendation. Where the psychiatrist starts treatment, the GP continues it under a shared plan. Where the question is ADHD, the assessment follows the NICE guideline NG87 structure, with availability and timing confirmed before booking.

Send us a note of what has been happening and a doctor will say which route applies or email team@thewellnesslondon.com.

What cannot be prescribed at a first visit

Controlled drugs. Stimulant medication for ADHD, benzodiazepines and Z-drug sleeping tablets, and strong opioids are not started by a doctor who has never seen you, whether GP or psychiatrist, and no lawful clinic in London starts them at a first appointment. ADHD stimulants follow a specialist diagnosis and are started and titrated by the psychiatrist over weeks. A person already established on them by another prescriber is assessed, the records are obtained, and continuation is arranged through the psychiatrist rather than promised on the day.

Antidepressants are not controlled drugs and a GP can start them at a first consultation where the assessment supports it, but a first appointment often should not. Where the picture is unclear, where the person is under 25, where alcohol is part of it or where the risk is not yet understood, the better first step is therapy, a physical check and a review within 2 weeks, and a doctor who says that is treating you rather than the appointment.

Which mental health services should you not buy

An online ADHD assessment completed in 40 minutes by questionnaire is the first, because a diagnosis the NICE guideline says needs a developmental history, a second informant and exclusion of other causes cannot be made that way, and no UK GP will take it into shared care. A private prescription for benzodiazepines from a telephone service is the second, and any clinic advertising it is breaching the rules that protect you.

A mental health assessment that does not check the body is the third. Thyroid disease, iron and B12 deficiency, sleep apnoea and alcohol each present as low mood or anxiety, and a consultation that scores a questionnaire and prescribes without a blood test has missed the first step. And a course of therapy bought before anyone has assessed whether therapy is the right modality is the fourth, since cognitive behavioural therapy, EMDR, interpersonal therapy and psychodynamic therapy suit different problems, and NHS Talking Therapies will provide the first course free.

What does a private mental health assessment cost in London

At the top of the market, 12-month programmes with a retained doctor run to £31,995 for one person and £49,995 for a family, where mental health is held by the same doctor across the year. Harley Street consultant psychiatrist first appointments run £500 to £1,200 and follow-ups £250 to £500, a full private ADHD assessment with report costs £1,000 to £1,500, and private psychotherapy runs £80 to £200 a session across a course of 12 to 20.

Beneath that sits a tier defined by its conditions rather than its price, questionnaire-only online assessments with no clinician who has met you, no physical check and no pathway when the answer is more than a prescription. At The Wellness, confirm assessment fees, appropriate blood tests, the care plan and any psychiatrist referral or appointment arrangements before booking.

• Family Office Programme: enquire for fees, duration, family coverage and care arrangements.

• Principal Programme: enquire for fees, duration and care arrangements.

• Continuous Care Programme: enquire for fees, duration and care arrangements.

• Complete Biomarker Assessment: confirm fees and appropriate tests before booking.

• Sleep assessment: confirm fees and any home sleep study arrangements before booking.

• Psychiatrist consultation: confirm the fee, duration and referral arrangements before booking.

• Comprehensive Blood Panel: confirm fees, appropriate tests and consultation arrangements before booking.

• Extended consultation: confirm the fee and duration before booking.

• In-person consultation: confirm the fee and duration before booking.

• Programme review: confirm the fee and review schedule before booking.

• Video consultation from £150: confirm duration and appointment availability before booking.

• Medical letters and certificates depend on clinical assessment. Confirm the fee and delivery timing before booking.

Why The Wellness is the best private mental health assessment in London

The first appointment decides which kind of help you need rather than assuming it is the kind the clinic sells, and that is countable. A person whose PHQ-9 is 12 and whose thyroid is normal is told a GP and a course of therapy are enough. A person whose history points to bipolar disorder or ADHD is referred to one with the appointment booked. A person whose ferritin is 9 is treated for the anaemia first.

The body is checked. Thyroid, full blood count, ferritin, B12, vitamin D and HbA1c are measured at an accredited partner laboratory where the history warrants, and a sleep study is arranged where the symptoms fit, because the commonest missed causes of low mood in a London clinic are physical. The plan is written down, the review is booked for 2 to 4 weeks, and the free NHS Talking Therapies route is given to everyone it suits, which is most people.

We also say no before you book. Controlled drugs are not started at a first consultation, a 40-minute ADHD diagnosis is not sold, and urgent or emergency risk is directed to the appropriate crisis service rather than waiting for a routine appointment. Places on the 12-month programmes are limited by the number of people one doctor can hold properly, so they begin with an allocation call.

Book an assessment and your doctor will set out the plan with you or call 020 3951 3429.

Related reading

This page is one spoke of the Private GP in London hub. The certificate that often follows a mental health consultation is covered in Private Fit Note in London, evidence for a university in Extenuating Circumstances Letter in London, the sleep apnoea that presents as low mood in Sleep Apnoea Test in London, and the blood markers checked first in Executive Blood Tests in London.

Frequently asked questions

What is the best private mental health assessment in London

The best private mental health assessment in London scores PHQ-9 and GAD-7, asks the risk questions, checks the physical causes with blood tests where indicated, follows the NICE NG222 pathway, gives the free NHS Talking Therapies route to everyone it suits and refers to a psychiatrist with the appointment booked only where one is needed. At The Wellness, video consultations are from £150; confirm extended consultation fees, duration and availability before booking.

How much does a private psychiatrist cost in London

Harley Street psychiatrist first appointments cost £500 to £1,200 with follow-ups at £250 to £500, and a full ADHD assessment with report £1,000 to £1,500. At The Wellness, confirm psychiatrist fees, duration and referral arrangements before booking. Phone consultations cost £59 and video consultations are from £150.

Do I need a psychiatrist or a GP for anxiety

For most anxiety, low mood and panic, a GP following the NICE pathway is enough, with therapy first and medication where needed. A psychiatrist is needed for suspected ADHD, bipolar disorder, any psychotic symptom, an eating disorder with physical compromise or depression that has not responded to 2 treatments. At The Wellness, a GP assessment can help identify the appropriate route. Phone consultations cost £59 and video consultations are from £150; confirm psychiatrist fees before booking.

Can I get ADHD medication at a first appointment

No. ADHD stimulants are controlled drugs that follow a specialist diagnosis under NICE guideline NG87, with a developmental history and a second informant, and are started and titrated by a psychiatrist over weeks. No lawful clinic starts them at a first visit. At The Wellness, confirm psychiatrist assessment fees and prescribing arrangements before booking.

Can I get therapy on the NHS without seeing a doctor

Yes. NHS Talking Therapies for anxiety and depression can be self-referred to online in England today, with a target that 75% of people start within 6 weeks, and it is free. At The Wellness every assessment gives that route where it suits, and a GP consultation can help identify an appropriate therapy route. Phone consultations cost £59 and video consultations are from £150; confirm availability before booking.

What if I am in crisis now

Call 999 or go to an emergency department if you are at immediate risk, call Samaritans on 116 123 at any hour, or call NHS 111 and select the mental health option. For non-emergency support at The Wellness, phone consultations cost £59 and video consultations are from £150. Confirm availability before booking; do not wait for a routine appointment if you need urgent crisis support.

The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Psychiatry is provided by consultant psychiatrists, and blood analysis is performed by accredited laboratories. If you are having thoughts of ending your life, call 999, go to an emergency department or call Samaritans on 116 123 at any hour. This article is general information and not a substitute for medical advice about your own health.

Send us your question about mental health support or email team@thewellnesslondon.com or call 020 3951 3429.