Access to mental health crisis care presents a “major issue”, a new report has found, with 26% of people who try to contact support services not getting the help they need.
The Care Quality Commission’s (CQC) community mental health survey 2017, shows that access to crisis care has worsened since 2014 and “paints a picture of a service under pressure and users struggling, at times, to access the support they need”.
The survey, which asks people about their experiences of NHS community mental health services, is the largest survey of its kind in the UK.
More than 12,000 people aged 18 and older who had used services at one of the 56 NHS mental health trusts between September 1 and November 20, 2016, responded to the survey.
Picker, an international healthcare charity who conducted the survey on behalf of the CQC, said the findings revealed “major issues” with access to care and support for wellbeing, with many areas found to be in need of improvement.
The CQC report, which was released on Wednesday, states: “The survey highlighted some areas where performance has declined over time, particularly around crisis care, the coordination of care, communication and access.”
It continues: “Survey results show that a higher proportion of respondents are not getting the help they need when they are experiencing a crisis.”
Some 26% of respondents said that they did not feel they got the help they needed from crisis care, compared to 21% in 2014.
“Many mental health conditions require support over a period of time,” Chris Graham, chief executive of Picker, said.
“Results show that too many users were adversely impacted by changes to the people they see. It is also concerning that a sizeable minority were not able to get the care they needed when in a crisis.”
Other key findings from the CQC report found:
25% of respondents reported they had not seen workers from their mental health services often enough to meet their needs in the last year – up from 21% in 2014.
68% of respondents felt listened to by their healthcare or social workers –down from 73% in 2014.
61% of respondents answered ‘yes, definitely’ to whether they felt they had enough time to discuss their needs and treatment – down from 65% in 2014.
Experiences seemed to vary across different population groups, particularly around overall care, respect and dignity, involvement, access and communication.
There was a general trend that respondents aged 50 and above reported more positive experiences.
There was a marked trend that the longer a person is in contact with mental health services, the worse the experience reported.
Dr Paul Lelliott, deputy chief inspector of hospitals (lead for mental health) at the CQC, said: “While it is good that two thirds of people in contact with community mental health services are satisfied overall with the care they are receiving, this still means that one in three people did not rate their experience so highly and it is disappointing that the results do not show improvements year-to-year.
“These services are important because they support the great majority of people who are under the care of specialist mental healthcare providers; including at times of crisis.
“They are also essential in working with people to ensure that their mental health does not deteriorate to the point that they require inpatient care.
“The finding that a higher proportion of people who sought help in a crisis were dissatisfied with the help provided is a particular concern.”
Another concern was the continuity of care, with 42% of respondents stating they experienced changes to the people who provided their care.
Of these:
47% did not know who was in charge of organising their care during that period of change.
23% said the reasons for the changes were not explained at the time.
31% reported that the impact of this was that their care got worse.
There were some positive aspects highlighted in the report.
Of the 76% who agreed with NHS mental health services on what care they would receive, 93% felt their personal circumstances were taken into account.
Eight two percent said the people they saw helped them with what was important to them.
Graham added that respondents had painted “a picture of a service under pressure and users struggling, at times, to access the support they need”.
“This is perhaps unsurprising given that demand for mental health services is increasing whilst many providers report shortfalls/ in staffing and difficulties in fulfilling their obligations within existing budgets,” he added.