Insight into community mental health care in 2017; a five part blog series
The publication of the 2017 Community Mental Health Survey, on 15 November 2017, offers some insights from over 12,000 people that use mental health services in England. Among other findings, the survey illustrates that many service users experience difficulties in accessing the care they need and when they need it.
In this first blog of a series of five, Picker’s Tiffany Gooden considers what the findings tell us about access to care, and experiences of crisis care.
Access to appropriate mental health care has been a particular government focus since the 2011 strategy No Health Without Mental Health.1 Emphasis has specifically been placed on better access to psychological therapies, crisis care and early intervention in psychosis. Great efforts have been made to achieve these; for instance, from 2011 to 2015 the Government invested around £400 million to make psychological therapies available to all who need them.1 So what do service users have to say about the current access to these types of care?
As part of the NHS Patient Survey Programme, the 2017 Community Mental Health Survey received feedback from over 12,000 people across 56 NHS mental health trusts in England. The results highlighted a range of areas in which NHS mental health services are doing well but also many ongoing issues, one of which is access to care.
The survey showed that 25% of service users felt they did not receive enough care to meet their needs; an increase from 21% in 2014. Responses to this question differed across mental health conditions. For example, of the respondents that had a non-psychotic condition (eg. common mental health problems and non-psychotic chaotic and challenging disorders) 32% said they did not see NHS services enough for their needs.
However, not all results were negative: the Government’s effort to provide better access for early intervention in psychosis has paid off. Eighty-eight percent* of respondents that were experiencing a first episode of psychosis said they were seen enough to meet their needs. In fact, compared to those with a non-psychotic condition, service users with psychosis reported that they received enough care.
This discrepancy in access across mental health conditions highlights the need for further action on delivering equity of access to treatment for all mental health service users, regardless of the severity of their symptoms.
Results for access to crisis care were unfortunately discouraging. The majority of service users (71%) said they knew who to contact if they have an out-of-hours crisis. However, of those who had tried contacting someone, 26% did not get the help they needed for their crisis. This was most reported amongst those with non-psychotic disorders as 29%* of these respondents said they did not get help.
Furthermore, despite the Government’s large investment to increase availability of psychological therapies, less than half of service users (47%) received therapy. No Health Without Mental Health expressed specific focus toward psychological therapies for those with depression and anxiety. However, 27%* of respondents with a non-psychotic condition said they did not receive therapy but would have liked to. These findings indicate clear evidence that more effort is needed.
Access to care also differs across age groups. For instance, younger and middle-aged (18-50 years old) service users reported more negatively to general access to care and older service users (66 and older) reported more positively.
Receiving enough access to mental health care does not necessarily equate to having more services available. A number of barriers including stigma, trust in care professionals and understanding symptoms can contribute to unmet needs of people suffering from mental health issues.3
Further investigation from the NHS is warranted to understand the reasoning behind these increasingly negative findings and the ongoing discrepancies across different types of mental health conditions and age groups.
However, there’s much more immediate action that can be done.
The survey results indicate the power of policy and resources. When specific services are targeted, improvements can happen albeit slowly. Though the concerning increase in people with certain mental health needs not getting the help they need when they need it prove that policy must focus on a wide range of different mental health conditions and resources must be spread across all areas of care and treatment. It is imperative that all mental health patients receive this attention and support at all times equally. To achieve this, dire improvements are needed and there is no time to be wasted, the NHS must work toward a more holistic approach to improve mental health care.’
In the next blog in this five part series, CEO of The Mix, which is a free, confidential information and support service for under 25s, considers what the findings tell us for young people’s experience of community mental health services in England.
*These results were produced from unweighted data.
- HM Government (2011). No health without mental health: A cross-government mental health outcomes strategy for people of all ages. London: Department of Health.
- Department of Health (2014). Achieving better access to mental health services by 2020.
- Gulliver, A., Griffiths, K. and Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10(1).