Are community mental health teams seeing less of their clients?

Comment: New NHS figures contain some surprises given the official narrative about mental health services

There are some interesting findings in the latest mental health bulletin released by the Health & Social Care Information Centre.

The number of contacts community mental health services had with patients decreased by 0.2% in 2012/13. Meanwhile, the proportion of people who accessed services and ended up needing hospital care at some point rose from 6.3% in 2011/12 to 6.6% in 2012/13. This is the first time in a few years that the number has risen.


Normally a drop as small as 0.2% or a rise as small as 0.3% wouldn’t catch the eye but this surprised me in the context of the official narrative that was recently used to justify cuts to NHS bed numbers since 2011 – i.e. that cost savings from ward closures are being invested in community mental health services, meaning more people are being kept out of hospital and treated at home (there are several problems with the idea that ‘more’ people being treated at home equals better care, but that’s for another day).

This year was the first year of data where providers were told to record the type of community service patients had contact with. Here’s the data that was returned:


The 2012/13 finding that overall contacts with community services have dropped may be an outlier – perhaps a boost in community appointments will be seen next year. Perhaps there are very good reasons that lie behind the drop. But, equally, the fall in community appointments might also signal that community mental health teams and crisis teams have less time to see growing numbers of people on their caseloads. I know several social workers in these teams who feel the much-promised investment in their services hasn’t materialised.

It will be interesting to see what trend emerges in coming years now that a dataset is in place.

One finding that was less surprising is that the proportion of mental health inpatients at NHS hospitals who were subject to legal restrictions under the Mental Health Act rose by 8.7% in 2012/13.

“These figures suggest a continuing trend for psychiatric beds to be increasingly occupied by people subject to some form of legal restriction,” the report states. This chimes with previous feedback from social workers.

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