Community mental health services are letting people down just when they need them the most

Experiences of community mental health services are consistently poor and the coronavirus pandemic will prompt a rise in people seeking help at crisis point, the care regulator has warned.

“Few positive results”

People reported poor experiences of NHS community mental health services relating to access to care, crisis care and support for wider needs and “few positive results”, the Care Quality Commission (CQC) said.

Many of those receiving care did not always receive support for their physical health needs or finding advice on managing finances or employment, the regulator said. Significant proportions felt they waited too long for services and that those they received were not enough to meet their needs, its report found.

The CQC called its findings “disappointing” and “a worry”, with the pandemic heaping pressure on services and negatively affecting the drivers of good mental health.

Not a new problem

But issues with mental health services existed before the pandemic. A speaker at a Unison conference in 2019 warned that “There are no resources. They’ve been cut and cut and cut.”. Pat Heron of the national women’s committee stated:

Mental health services are broken and heading for crisis. All we see is virtual money being moved from one service to another. There’s no new money. Nurses say it’s like being at war, on a battlefield, and you know you’re not winning.

Its 2020 Community Mental Health Survey ran between February and June, during which time the first national lockdown was imposed. Some 17,601 people who were receiving treatment between 1 September and 30 November last year were asked about their experience of services over the last 12 months.

The survey found:

• More than a quarter of people (28%) would not know who in the NHS to contact if they had a mental health crisis out of office hours.
• Of those who did try to reach someone, 17% said they did not get the help they needed and 2% were not able to make contact.
• A quarter (24%) of people who received NHS therapies in the last year felt they had not seen services enough, and 44% felt they waited too long before treatment started.
• Almost six in 10 (59%) said they were “definitely” given enough time to discuss their needs and treatment.
• Positive responses included 97% of people who were told who is in charge of organising their care and services saying they knew how to contact this person if they had a concern.
• More than a third (36%) were not given support for their physical health.
• 43% were not signposted to financial advice or benefits, and 43% were not pointed towards advice on keeping or finding work.
• Over a third of people (37%) did not receive support in joining a group or taking part in an activity, but would have liked this.

“Economic uncertainty”

The report reads:

In summary, many people have not received help, advice or support from NHS mental health services for physical health, social interaction or to support financial stability.

These are also the areas that are likely to be affected by Covid-19 as a result of restricted activity during lockdown and economic uncertainty.

Dr Kevin Cleary, CQC’s deputy chief inspector of hospitals and lead for mental health, said:

Some people will have been unable to attend their regular appointments with community mental health teams during the first national lockdown, which started in March, this will almost certainly have a knock-on impact on the number of people seeking crisis care.

It is therefore disappointing to see in this survey, that people are having poor experiences of community mental health services, particularly in relation to crisis care, access and involvement in decisions about their care.

It is also a worry that people didn’t always get help with their physical health needs or with financial advice and benefits, particularly in light of the wider health and socio-economic impacts of the pandemic.

There is likely to be even more demand for the vital services provided by community mental health teams as a result of the pandemic.