NHS mental health service users report poor experiences of care – and worsening mental health.

People using community mental health services in England are often unable to access the support they need, according to results from a new survey published today – and changes to care during the pandemic are exacerbating existing mental health problems.

The survey, coordinated by Picker for the Care Quality Commission, received more than 17,000 responses from people in contact with one of England’s 54 NHS community mental health service providers. Respondents were seen by mental health services during a period of 2020 that included the second national lockdown due to the Covid pandemic, and the survey itself was conducted in part during the third national lockdown.

Unsurprisingly, the Covid pandemic casts a shadow over the results. A number of questions asked specifically about people’s experiences during the pandemic, and their results were alarming:

• Nearly half of service users (48%) felt that changes in their care and treatment due to the Covid pandemic had led to their mental health getting worse.
• Less than half (48%) said care and services were “always” available when they needed them. One in six (17%) said services were not available, and 29% said they were only “sometimes” available.

There was also evidence of disruption to routine care:

• A quarter of current service users (27%) said that they had not seen NHS mental health services enough in the last 12 months – a 4% point increase from last year’s survey.
• More than one in three (34%) had not had a meeting to review their care in the last 12 months – a 9% point increase from last year’s survey, when 25% said this.

Despite this, there were some positives amongst the survey findings. People accessing care via video call technology reported more positive experiences on average for questions relating to communication, accessing care, being treated with respect and dignity, and overall experiences. This suggests that some elements of remote care that have been introduced or extended during the pandemic may be of ongoing benefit to service users – although it is also important to note that people who had telephone consultations reported poorer experiences.

Commenting on the results, Chris Graham, Picker’s Chief Executive, said:

“It has been well reported that the pandemic and changes to day-to-day life, including social distancing, have taken a toll on mental health across the country. At the time this survey was conducted, rates of depression in adults were around double their pre-pandemic levels, with one in five people experiencing some form of depression. It is understandable that these challenging times place mental health services under tremendous pressure – and that is borne out by the difficulties and gaps in care reported by service users in this survey.

Equally, it is important to remember that these results – alarming as they are – reflect only the experiences of people already in contact with NHS mental health services. A further 1.2 million adults are on waiting lists for mental health services and as of August 2021 referral rates remained 13% higher than before the pandemic in August 2019. There is an urgent and growing need for increased financial support to mental health services, as well as a long-term plan to train and recruit more specialist mental health professionals, to address this.”

A summary of the results can be seen in our infographic.

Notes for Editors

• The survey is commissioned and published by the Care Quality Commission, the independent regulator of all health and social care services in England.
• People were eligible for the survey if they were aged 18 or over, were seen face-to-face (including via video conference) or had a telephone consultation between 1st September and 30th November 2020, and had had at least one other contact with mental health services either before, during, or after this period. People who were seen only once for an assessment were not included; nor were people primarily receiving care from any of the following services: drug and alcohol; learning disabilities; specialist forensic; Improving Access to Psychological Therapies (IAPT); chronic fatigue/ME; psychosexual medicine; or gender identity.
• The survey was conducted between February and June 2021. 17,322 responses were received, representing a response rate of 26.5%.
• Details about how the survey was administered and full results are available at https://nhssurveys.org/surveys/survey/05-community-mental-health/year/2021/.
• Chris Graham is available for media interview. To arrange your interview, or if you have any other media enquiries, please contact Greig Box Turnbull gbt@fortitudecommunications.com, or the Communications Manager at Picker, Emma Newton – emma.newton@pickereurope.ac.uk.