Crisis care neglected in community mental health services

Samantha Guymer, Senior Research Associate at Picker, reveals how Accident & Emergency departments (A&E) are affected by the lack of crisis care within community mental health services.

Access to community mental health services remains an issue as waiting lists to receive treatment continue to grow. The latest figures from NHS Digital show that 2.7 million new referrals were made this year (January 2022 to July 2022), a 6% increase from this period in 2021 and a 28% increase from 2020. These figures demonstrate that the aftermath of the pandemic and the ongoing cost of living crisis are taking their toll on the nation’s mental health.

The 2022 Community Mental Health Survey received feedback from over 13,000 service users who received treatment during September and November 2021. Results have revealed that access issues continue even once you have entered the system, with only 2 in 5 (40%) service users saying they have ‘definitely’ seen NHS mental health services often enough for their needs, the lowest proportion since 2014. And only 55% of service users stated they ‘definitely’ had enough time to discuss their needs and treatment, a statistically significant downward trend since 2018.

Another concern highlighted in the 2022 results was access to crisis care. The charity Mind defines a mental health crisis as our minds being at a melting point, where we can’t carry on anymore; we are at immediate risk of self-harm or suicide or experiencing extreme anxiety, a panic attack, or even a psychotic episode. Results found that 28% of service users did not know who to contact outside of office hours within the NHS if they had a crisis, a significant increase since the 2021 survey. Of those who did know who to contact, almost a quarter (22%) reported not getting the help they needed, and 1 in 5 (19%) said they waited too long to speak to someone. These insights highlight the urgent need to improve access to crisis care. 

The delays observed in accessing community mental health care have placed demands on A&E departments due to a rise in attendance for mental health conditions. From April 2021 to March 2022, almost 300,000 people attended A&E with a mental health diagnosis, a 7% increase from 2020 to 2021. With A&E services already overwhelmed by attendance above pre-pandemic levels, it is essential, for both the health of the public and management of A&E departments, that access to care through community mental health services is prioritised.

In June 2022, the UK government announced an investment of £150 million to bolster NHS mental health services over the next three years. Specifically, this is to support access to care within the community to help people in crisis outside of A&E. Funding will also provide alternatives to hospital admission, therefore further reducing admissions for people in crisis. Additionally, within the NHS Mental Health Implementation Plan, a commitment of £2.3 billion by 2023/24 would be invested to enhance the quality of mental health services. 

The 2022 Community Mental Health Survey reports the worst results to date, highlighting the dire need to improve community services further. While the additional funding is welcomed and is a step in the right direction, there is an urgent need for further action to address the issues observed.

You can find the results of the latest 2022 Community Mental Health Survey here and an infographic summarising the results here.