Regulator says access to therapies and crisis care must improve

Access to talking therapies, out-of-hours crisis care and the management of medicines in community mental health care must improve, inspectors said today. 

The first ever Healthcare Commission review of community mental health services praised them for generally performing well but said long-standing problems remained.

The review of local implementation teams, which are responsible for delivering services, found 9 per cent were excellent, 45 per cent good, 43 per cent were fair and only 3 per cent were weak.

But 84 per cent of LITs rated fair or weak on the management of medicines and only 5 per cent received the top score for telling patients about possible side effects of medication.

In a survey of 19,000 community mental health service users, also published by the commission today, 77 per cent rated their overall care as excellent.

But the proportion being offered talking therapy has fallen from 40 per cent to 39 per cent since last year.

Fewer than half of service users said they had the phone number of someone from the health service who they could contact for out-of-hours crisis support.

A national report on the findings of the review is expected later this year.

Paul Farmer, chief executive of Mind, said:

“It’s encouraging that most people have a good experience of the community practitioners that they see. But we’re concerned about the large number of people who don’t have access to basic treatents, like cognitive behavioural therapy (CBT), which is simply not available in many areas of the country, even though the Government’s own advisers, NICE, have recommended CBT as a first-line treatment for a range of mental health problems.”

Andrew McCulloch, Chief Executive of the Mental Health Foundation, added: “Patients with mental health problems are being denied a basic level of care; in any other care setting these findings would be unacceptable. There has been no improvement in the last couple of years to community mental health services and the current round of cuts are set to see these standards worsen.

“Only 39 per cent of the respondents received counselling from NHS services in this year, yet 57 per cent wanted it. The demand for talking therapies comes as no surprise; they are effective. The Government has a duty to provide a range of treatment options available to people with mental health problems, medication is being relied upon because of a lack of alternatives.”