Healthcare Commission Report — Published: 3rd September 2007

Community mental health services show improvements, but concerns remain over social inclusion and access to counselling

Users of community mental health services say there have been some improvements in their care, according to a Healthcare Commission survey published today (Monday 3 September 2007).

The relationships between service users and their psychiatrists continue to improve year–on–year. Meanwhile, a greater proportion of those with more complex mental health needs know who their care co–ordinator is and are being offered copies of their care plan.

Access to out of hours crisis care via telephone has improved markedly in the past year. Last year only 49% of service users said they had an emergency contact number. This has risen to 52%, with the vast majority getting through to someone within an hour.

But this still leaves almost half of service users without access to out of hours crisis care. Meanwhile, more than one in three service users who wanted counselling say they did not get it.

Also worrying was the lack of progress in helping service users access benefits or find work. Almost a third of those who would have liked help with benefits did not receive it.

Likewise, only 49% of those who wanted help finding work were offered it. Only 20% of people using mental health services reported that they were in paid work. The national employment rate for all people of working age, according to the Office of National Statistics, stands at 74% (1).

Furthermore, only one in two service users who wanted information on local support groups got it.

Community mental health services must also address the needs of carers and those who provide support for people with on–going mental health conditions. It is therefore a concern that 40% of respondents said their relatives or carer had not received enough support from health and social services.

The national survey, co–ordinated by the National Centre for Social Research (NatCen), was carried out in spring 2007 by 69 trusts, and published by the Healthcare Commission. Now in its fourth year, it provides a ‘snapshot’ of the experiences of people using community mental health services in England.

Currently, one in six adults in the UK has a mental health disorder. Mental health services are therefore a crucial part of modern healthcare. Community–administered mental health services are intended to go further than traditional mental healthcare by providing services outside of specialist hospitals, and around individuals’ schedules and needs.

Of the 15,900 people surveyed, 76% felt the services they received were ‘good’, ‘very good’ or lsquo;excellent’. This is on a par with previous years.

The central plank of community mental health services is the Care Programme Approach (CPA). Under the CPA, service users should have a care plan to identify their needs and explain their care. Seventy–four per cent of those with more complex mental health needs said they had, or were offered, a copy of their care plan — up three percentage points compared to last year.

This plan should be reviewed regularly. And although more service users overall are having yearly reviews (53% compared to 49% in 2004), more than one in four of those with more complex and enduring mental health needs — and are thus in need of more frequent contact – said they had not had a review in the past 12 months.

Anna Walker, Chief Executive of the Healthcare Commission, said:

“The people who use community mental health services appear to be satisfied with the service they get overall. It is particularly pleasing to see the improvement in co–ordinated care for those with more complex mental health needs.

“The general trends are encouraging, particularly given that many trusts are still getting to grips with providing care to service users within their own communities.

But this shouldn’t disguise the problems — problems that have been going on for too long.

“For instance, carers and family members can provide invaluable support to people with mental health problems. It’s very important that they in turn receive the support they need; otherwise there is a risk that the burden becomes too great for them to manage.

“There are a number of factors associated with improving social inclusion for service users; these include finding jobs and receiving sufficient support at home and within local communities. These results show there is still much to be done. It is vital that trusts and local partners strengthen the means by which they address this problem. We will be working with other regulators to encourage an effective partnership approach to this issue.”

Each of the 69 trusts has been given a benchmark report, detailing their performance against the national averages. This will enable them to highlight, and address, areas of concern locally.

 
1) The figure from this survey (20% in paid work) is based on all respondents aged 16–65 for consistency with results presented elsewhere. A further 12% were retired, in full–time education, or in voluntary or casual work: additionally it is likely that many respondents were unable to work because of their mental health condition.

The national employment rate from the Office of National Statistics (74%) is based on all people of working age (men 16–64 and women 16–59). While not precisely comparable, the figures nonetheless show that users of community mental health services are, for whatever reason, considerably less likely to be in paid work than the population as a whole.

For more information visit the Healthcare Commission Website