Healthcare Commission exposes community mental health gaps

The Healthcare Commission warned today of continuing gaps in the provision of essential community mental health services in its annual survey of users.

The poll of more than 14,000 users, the commission found that 45% had not been given access to out-of-hours crisis services, though this was down from 48% last year.

Sixty-two per cent of people also said they had not been offered counselling, even though nearly a third of those would have liked the service. The figures have not significantly improved from last year’s survey.

A quarter not involved in deciding care plan

It was also found that 24% of service users had not been involved in deciding their care plan – a figure that has remained broadly unchanged since 2005 – with 16% saying their diagnosis had not been discussed with them. In addition, 32% of people who had been given a new prescription had not been told about possible side effects.

Overall satisfaction with services remained high, with 78% rating their care as “excellent”, “very good” or “good”, in line with performance since 2004. 

Healthcare Commission chief executive Anna Walker said that most “key aspects” of care had been highly rated, but said more needed to be done on improving access to talking therapies and out-of-hours care, and involving users. 

Steve Shrubb, director of the NHS Confederation’s Mental Health Network, which represents the majority of mental health trusts, said: “We welcome these findings while realising that there is still more to do.”

Under Department of Health plans, the Care Programme Approach – which sets out guidelines on care management for those receiving mental healthcare – will be restricted to people with more complex needs from next month.

Walker added: “When the new system comes into effect, trusts should ensure that the principles of the CPA should continue to apply to every service user and that the improvements made over the last few years are sustained and built upon.”

Mental Health Foundation head of policy Simon Lawton-Smith said that around 350,000 people would have CPA withdrawn – around three-quarters of people currently receiving it.

He warned: “Given the known shortfalls in care for this group and pressures on local budgets, the loss of Care Programme Approach status for so many people could also mean a loss of services.”

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