22 November, 2018

News > Community mental health services: little to no progress in key areas

The results are in from the 2018 Community Mental Health Survey. The 2018 survey received responses from nearly 13,000 people age 18 and older who used services at one of the 56 NHS mental health trusts between 1st September and 30th November 2017.

The results indicate that while there have been improvements in people’s experiences of crisis care, there has been little progress in many other areas of community mental health services, with some key areas becoming worse in the last year.

Areas of routine and preventative care that help service users to maintain their mental health within their everyday lives, such as access to services, continuity of care and wider support, were found to show no improvement or to have worsened since the 2017 iteration of the survey. Less than half (43%) of people said they had ‘definitely’ been seen often enough for their needs, a reduction of 1 percentage point from last year and a significant decline from 47% in 2014. Additionally, just over half (58%) of people felt they ‘definitely’ had enough time to discuss their needs, dropping 3 percentage points from last year.

Last year we talked about the concerning findings regarding people’s experience of continuity in their care and regrettably, this year’s results showed no improvement, with 42% of respondents saying they experienced changes to the people who provided their care. Furthermore, 32% of these respondents said the impact of this was that their care got worse, this has worsened by 1 percentage point from last year. Providing a sense of continuity on someone’s care journey is vital to ensuring that people have good overall experiences.

Objectives for 2020/21 from the Five Year Forward Plan included targeting an increase in access to psychological therapies. Unfortunately, 28% of people that would have liked to access NHS therapies did not receive them.  Out of all respondents, less than half (46%) had received NHS therapies that did not involve medicines for their mental health needs – and of these:

  • 96% said these therapies were explained in a way they could understand
  • 83% said these therapies had helped their mental health
  • 75% said they waited six months or less for their NHS therapy to begin

The importance of supporting people with activities and daily living needs is a core element of person centred care, and to support a person with a mental health condition requires approaching them as a ‘whole person’ with physical, social and environmental needs take into consideration alongside their clinical requirements.

Disappointingly, 39% of respondents that would have liked help or advice finding support with physical health needs did not receive it, this was 3% percentage points worse than in 2017. Furthermore, almost half (47%) of people who wanted help or advice with finding support for financial advice or benefits did not receive it, this is the worst it’s been since 2014 (44%).

Another unfortunate finding is that only 61% of respondents rated their overall experience of care as a seven or above (from a scale of 0 to 10, with 10 meaning they had a ‘very good experience’).

A priority action of the governments Five Year Forward Plan is to improve the crisis response service across the NHS. Encouragingly, nearly three quarters (71%) of respondents said they knew who to contact if they had a crisis, of these, 79% said they received help when contacting them in the last 12 months.

Chris Graham, CEO of Picker, said:

“The autumn budget statement included an announcement of £2bn in additional funding for mental health, including the establishment of new mental health crisis services. Crisis services are undoubtedly important, because people experiencing a mental health crisis need to be able to depend on high quality services that they can access quickly and easily. Today’s results show improvement in this area prior to the budget statement, which is very welcome and that we hope to see continue.

Alongside improving crisis care, however, it is important that services are able to support the ongoing wellbeing of people with mental health problems. This includes providing the routine and preventative care that helps people to manage their conditions and to ensure that they do not reach the point of crisis. This is essential to truly person centred services, so it is disappointing that today’s results show worsening of people’s experiences around some core elements of community mental health services. In future, it is important that mental health providers are supported to maintain and improve these services alongside crisis care, and that we do not rely too heavily on crisis services as a safety net for people who could avoid such a need.”

Notes to Editors:

  • Picker is an international charity working across health and social care. We believe in high quality person centred care for all and promote this by measuring and encouraging the use of staff and patient feedback.
  • The 2018 Community Mental Health Survey was co-ordinated by Picker on behalf of the CQC with questionnaires distributed between February and June 2018.
  • 12,796 patients responded to the survey
  • Statistics that make a historical comparison to 2014 have not been tested by our researchers to ascertain if they are statistically significant.
  • Full details of the survey methodology, questions, and results are available on the dedicated survey website at https://www.cqc.org.uk/publications/surveys/community-mental-health-survey-2018
  • To arrange an interview with one of Picker’s spokespeople, or if you have any other media enquiries, please contact Helen Thorne on helen.thorne@pickereurope.ac.uk

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