Claire Murdoch, one of the most influential figures in British mental health policy, has resigned from her role as NHS England’s national mental health director after nine years. In a blunt resignation letter to Sir Jim Mackey, Murdoch wrote that it had become “common knowledge that change at the top is wanted” and admitted she could no longer lead the sector “when the political leadership don’t want to engage with me.”
Her decision sends shockwaves through the NHS at a time when mental health services are already under enormous pressure. Murdoch is not just another departing executive. She has been the public face of national mental health policy since 2016, overseeing a transformation in how severe mental illness is treated in both hospitals and the community. Her tenure included expanding the workforce, creating 24/7 crisis services, rolling out mental health support teams in schools, and embedding psychiatric liaison in every major acute hospital. For many patients and campaigners, she was seen as both reformer and advocate.
Yet her resignation letter strikes a far more sobering tone. Murdoch raised alarm about the shrinking proportion of NHS funding going to mental health, noting it fell last year and will again this year. “It likely will continue to do so over the next three years. I hope I am wrong,” she wrote. This echoes recent warnings that the mental health investment standard, once ring-fenced, is being quietly eroded. Without protected budgets and multi-year planning, she argued, progress risks unravelling.
Murdoch also highlighted persistent inequalities, particularly the premature mortality faced by people with serious mental illness. She admitted that progress on tackling this injustice has been “insufficient,” a candid assessment of the gap between rhetoric and reality. Some of these changes, she said, could be achieved without major new investment, but much would require significant funding.
The political backdrop is hard to ignore. Her letter makes clear that her exit was not purely voluntary but triggered by what she described as a “widely known” ministerial appetite for new leadership. The Department of Health and Social Care was quick to issue a pointed response, stating that progress had been slower than hoped despite “a big funding increase.” The message was clear: the government is seeking a reset.
Advocacy groups reacted with dismay. Mark Winstanley, CEO of Rethink Mental Illness, called Murdoch “a towering figure in the mental health field” who championed lived experience and voluntary sector voices. He credited her with steering the sector through the pandemic, austerity, and the cost-of-living crisis while still pushing for systemic reform.
Murdoch herself sought to strike a balance between pride and concern. She reflected on achievements such as ring-fenced investment, workforce growth, and the embedding of lived experience in policymaking, but warned that “a brand new, radical approach” is now politically inevitable. After 43 years as a mental health nurse, she concluded her letter with a plea that the sector “deserves the best talent, leadership and innovation that there is.”
Her resignation raises bigger questions about the direction of NHS mental health policy. The long-promised five-year plan for the sector remains unpublished, key commitments have been stripped from the NHS planning guidance, and mental health barely featured in the government’s ten-year strategy. Without sustained investment, many fear that years of incremental progress could stall, leaving patients once again fighting too hard for parity of care.
Claire Murdoch’s exit is more than a changing of the guard. It is a warning shot about the fragility of gains in mental health services and the risks of political drift. The future of the sector will depend not just on who replaces her but on whether political leaders are prepared to back rhetoric with real commitment. Mental health has always required champions. With Murdoch stepping aside, the question is whether her successor will be empowered to deliver the change she has fought for, or whether the sector will slide backwards just when patients need it most.
