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Poor access to mental health services

11 September 2008

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A Healthcare Commission survey of people using community mental health services has shown continued improvements in care.

A larger percentage of service users say that they have confidence in mental health professionals, receive copies of their care plan and have a number to contact out-of-hours when in a crisis situation.

Overall, most respondents continued to rate their care highly, with 78% describing it as “excellent”, “very good” or “good”.

But the survey also shows there is still some way to go before community mental health services are accessible to all people who need them and include all service users in decisions about their care.

Under the Care Programme Approach (CPA), established in 1991, all service users should know who their care coordinator is and should receive a copy of a care plan, which they should have been involved in developing and agreeing. They should also have regular care reviews to discuss their care and treatment with health professionals.

In 2008, 74% of respondents say they know who their care coordinator is, up from 67% in 2004. Over the same period, the proportion of service users who say they received a copy of their care plan increased from 49% to 59%. The proportion reporting not having had a care review in the last year has fallen from 51% in 2004 to 45% in 2008.

However, the survey shows that more attention needs to be paid to involving people in their care. In 2008, almost a quarter of people say they were not involved in deciding what was in their care plan, suggesting no significant improvement over previous years. Furthermore, 16% of service users say their diagnosis was not discussed with them.

The survey also showed room for improvement around access to counselling services such as talking therapies. Of the 62% of service users who did not receive any counselling almost a third of those (32%) would have liked to.

There was continued improvement in the number of people who say they have the number of someone from their local NHS mental health service to call out-of-hours, up from 49% in 2004 to 55% in 2008. However, this still leaves 45% of service users without access to a crisis number to call out-of-hours.  

The survey also showed continued improvement in service users’ relationships with healthcare professionals. A total of 75% report that they “definitely” had trust and confidence in their community psychiatric nurses, up from 73% in 2004.

Commenting on the survey results, Anna Walker, chief executive of the Healthcare Commission, said: “The survey shows steady improvement in how service users rate key aspects of their care. This is good news for trusts and good news for the people who access community mental health services. But more must be done to improve access to care, in particular to talking therapies and out-of-hours crisis care, and to involve people in decisions about their treatment.”

Healthcare Commission