Mental health systems in the US and UK have entered 2026 under pressure from funding shifts, rising demand and fragmented service pathways, with clinicians warning that limited regulated treatment routes are contributing to delays, discontinuity of care and increased reliance on poorly governed alternatives.

In the US, the administration recently cancelled nearly $2 billion in Substance Abuse and Mental Health Services Administration grants before reversing the decision, prompting providers and grant recipients to warn of disruption to staffing, programmes and continuity of care.

In the UK, The Guardian reported that the NHS is on track to overspend £164 million on ADHD services, with rising demand for assessments and growing use of private providers operating outside standard NHS pathways. Patients face long waiting times through regulated routes, while oversight of alternative clinics has been questioned.

Clinicians say these developments highlight structural weaknesses in mental health care systems when demand spikes or funding changes, leaving too few regulated routes to keep patients in supervised treatment. The result can be longer waits, fragmented care and patients moving between services without consistent follow-up.

Against this backdrop, clinicians from Flow Neuroscience argue that pressure on services is accelerating the need for multimodal care models that combine pharmacological, psychological and regulated non-drug interventions.

“When systemic care depends on one main route, e.g., SSRI-based drugs for depression, any disruption in that system shows up immediately as a gap,” said Kultar Singh Garcha, nhs gp and chief medical officer at Flow Neuroscience. “Multimodal care could change the patient journey – in fact, it is how other areas of medicine manage chronic conditions, but it hasn’t reached mental health care yet.”

Multimodal care refers to combining multiple interventions earlier in treatment pathways, such as psychotherapy, medication and regulated non-drug therapies, with closer monitoring and faster adjustments when treatments are not effective.

In December 2025, the FDA granted premarket approval to Flow Neuroscience’s Flow FL-100 device, listed by the agency as a cranial electrotherapy stimulator for the treatment of depression. The approval represents the first premarket authorisation for a home-use, non-invasive brain stimulation device specifically indicated for depression, and is seen by clinicians as a regulatory signal that non-drug interventions are moving into mainstream medical frameworks.

“Approval alone didn’t (and won’t) solve access or capacity,” Garcha added. “What matters is that slowly, it changes the rules. It creates a medical standard for a non-drug option, and whether it becomes part of routine care, rather than sitting in a gray zone between wellness marketing and medicine, depends on how health systems choose to integrate it.”

In the UK, transcranial direct current stimulation (tDCS), the technology used in the Flow FL-100 device, has been used under clinical supervision for several years, including within some NHS pathways. However, clinicians note that the presence of regulated non-drug options does not eliminate backlogs or funding pressures in other areas, such as ADHD services, but may illustrate how integration could work in practice through supervised access, clinician oversight and outcome tracking within healthcare systems.

Brain stimulation approaches are being tested across hospitals and supervised home settings, and interest from patients has increased. Clinicians say misconceptions remain, particularly around older forms of brain stimulation.

“Some people may hear ‘electric treatment’ and think of electroconvulsive therapy,” said Hannah Nearney, clinical psychiatrist and UK medical director at Flow Neuroscience. “tDCS is not ECT. It does not induce seizures, it does not require anaesthesia, and it does not use the same intensity or mechanism. It uses a gentle, low-level current under clinical protocols. It has to be clearly explained that modern alternatives are nothing like these old techniques – and this is the first step to general acceptance.”

Researchers are also investigating potential applications of tDCS and related neuromodulation techniques beyond unipolar depression, including pain and bipolar depression, although clinicians emphasise that evidence requirements and regulatory pathways will differ by indication and that larger controlled trials are required before routine clinical adoption.

“If we want a mental health system that can cope, we need flexibility built in,” Nearney added. “Multimodal care is that flexibility, and without it, demand will keep outgrowing the treatment pathways, no matter how much funding is added.”

The commentary from Flow Neuroscience highlights both operational challenges facing mental health systems and the company’s positioning around regulated non-drug therapies. While the FDA approval represents a regulatory milestone, integration into routine care will depend on reimbursement, clinician adoption and health system capacity. The broader discussion reflects growing interest in diversified treatment pathways as demand for mental health services continues to increase across major healthcare systems.