‘Little or no improvement’ in user perception of community mental health services, survey finds

An annual survey into user experiences of community mental health services has found many people continuing to report problems with the quality of care they receive.

The results of the Care Quality Commission (CQC) research, published last week, found there had been “little to no improvement” in terms of service gaps identified in the previous year’s survey.

In many cases, measures of quality had declined slightly between 2014 and this year’s study.

A quarter of the 12,000-plus respondents (up from 21% in 2014) said that, over the past year, they had not seen someone from NHS mental health services often enough for their needs.

Fewer than one in four (39%) ‘definitely’ knew who to contact in a crisis, down from 45% three years ago.

Care planning and coordination

Respondents identified a series of issues around care coordination and planning, and how they are involved in it.

Just over a quarter (26%) of people said that they had not been told who was in charge of coordinating their care and support, up from 23% in 2014.

A similar number (24%) said they had not agreed with somebody from NHS mental health services what care they will receive.

More than four in ten had experienced changes over the previous year in terms of which practitioners they see. Fewer than half of these respondents (47%) said these changes had been ‘completely’ explained to them, and almost one third (31%) said their care had got worse following them.

While most respondents (68%) said the professionals they had seen most recently listened carefully to them, this was a decline of five percentage points since 2014.

Access to wider support

Another area of concern related to the extent to which professionals helped respondents access wider support:

• Thirty-six percent said they would have liked help or advice with finding support around physical health needs, but did not get it.
• Only 32% said that in the previous 12 months, NHS mental health services ‘definitely’ gave them help or advice with finding support for financial advice and benefits. Just 27% said similarly when asked about help with finding or keeping work.
• Almost half (49%) of respondents who would have liked access to peer support said they did not get any information from NHS professionals.

More positively, almost two thirds (64%) rated their overall experience of care as a seven (out of 10) or above.

Almost three-quarters (72%) of respondents said that overall, in the last 12 months, they felt that they were ‘always’ treated with respect and dignity by NHS mental health services.

‘Mixed picture’

Andy Bell, deputy chief executive of the Centre for Mental Health, said the survey presented a “mixed picture” of people’s experiences of community mental health services.

“It is worrying that a significant proportion report not getting help with key areas such as physical health, finances and employment given how vital these are to improving people’s lives,” he said. “It’s also a cause for concern that in a number of key areas – most notably in crisis services and care coordination – people’s experiences were less positive in 2017 than previously.”

Last year’s NHS England-commissioned Mental Health Five Year Forward Review, Bell added, represented an “important opportunity” to bring about significant national improvements in many of these areas and ensure people get help at the right time.

Dr Paul Lelliott, the CQC’s deputy chief inspector of hospitals and lead for mental health, said it was “disappointing” that the survey results did not show year-on-year improvements.

“We expect providers to review their results very carefully,” Lelliott said. “We will continue to use these findings to plan our inspections and will be looking carefully at the action plans that providers have developed in response to their local survey results.”