What does the 2024 Community Mental Health Survey tell us about people’s experiences of NHS mental health care?
Since its inception in 2003, the Community Mental Health Survey has played a pivotal role in gathering feedback from people receiving mental health care and assessing the quality of services provided by NHS Community Mental Health Trusts across England.
In 2023, the survey underwent a significant redevelopment, transitioning to a mixed-mode methodology and, for the first time, extending the eligibility criteria for participation to younger people aged 16 and 17. At a time when evidence shows a rise in mental health issues among adolescents in England¹, these changes ensure that the voices of younger people are being heard.
While this redevelopment has introduced necessary, valuable improvements, it means direct comparisons with pre-2023 data are no longer possible. The findings from the 2024 survey do, however, offer an opportunity to identify new emerging themes, and improve our understanding of existing challenges in the delivery of community mental health services: including access to care, service integration, person centredness, and poor experiences reported by younger people.
Concerns about access to care
The NHS Long Term Plan (2019) stated² that everyone should have access to quality, timely mental health care when they need it. Despite this, 2024 data shows that one in three mental health service users (33%) reported waiting more than three months between their assessment and their first appointment with an NHS mental health professional. It is concerning that 60% of this group said they were not offered support during this time, and that their mental health got worse while they waited.
Our data on access to care, coupled with recent NHS data showing that the number of people still waiting for mental health treatment after 18 months is eight times higher than those awaiting physical health care³ ⁴, highlight the urgent need to enhance community mental health services to reduce waiting times and ensure timely access to care.
The Long Term Plan also outlined commitments to broadening the provision of mental health services. Existing research⁵ demonstrates the importance of multi-sector partnerships and community-based services in achieving this goal. Such initiatives could not only improve access to mental health care but also address structural and social inequalities, enhancing individual mental health outcomes while promoting stronger, healthier communities.
Delivering person centred care
Just over half (52%) of respondents said they ‘always’ felt listened to by community mental health professionals – but nearly one in three (32%) felt they were only ‘sometimes’ listened to, and 15% did not feel listened to ‘at all’. When asked if they got the help they needed, 23% of respondents said that they did not, an increase of 1% point compared to 2023.
Just 41% of respondents felt they were ‘definitely’ supported in making decisions about their care and treatment, while only half (57%) had a care review meeting to discuss how their care was working for them. These findings suggest that despite a policy emphasis on person centred care, there is still a lot of room for improvement in its delivery.
Accessibility and inequities in care
In 2024, 35% of respondents indicated that they needed support, an increase of 7% points from 2023 – a notable increase. More than half (56%) reported, however, that their NHS mental health team did not ask whether they needed support to access their care. When support was provided, just under one in three (28%) said that it did not meet their needs.
The 2024 survey results also reveal concerning evidence of a disparity between the experiences of younger and older service users. Younger people (aged 16 to 35) are more likely to report poorer experiences across all areas of their care. Subgroup analysis also shows a similar pattern among people aged 36 to 50, with ‘support for finding or keeping work’ being the only area where this group reported significantly better than average experiences.
Sustaining progress
Despite evidence of continuing challenges, the 2024 survey highlights some positive aspects of service user experience. Two in three respondents (64%) felt that they were given a choice about how their care and treatment would be delivered, and 72% felt in control of their care. There was also a statistically significant 5% point increase in the proportion of younger people accessing Child and Adolescent Mental Health Services (CAMHS)⁶ who reported that they were ‘definitely’ given enough time to discuss their needs and treatment (from under 39% in 2023 to over 43% in 2024). Ensuring that younger people feel heard and supported was an essential element of the NHS Long Term Plan, and this shift suggests positive progress towards this goal.
Delivering community mental health care fit for the future
The 2024 findings provide an important insight into the experiences of people who use NHS community mental health services and show some encouraging improvements compared to 2023. However, they also highlight ongoing challenges and emphasise the importance of person centred care. Every person accessing mental health services should feel listened to, respected, and empowered. Listening to and acting on service user feedback is key to creating care and treatment that meet their needs in practice.
These results offer timely and valuable evidence for the ongoing Health and Social Care Committee inquiry into community mental health services and the government’s forthcoming ten-year health plan, emphasising the importance of person centred, community-based mental health services.
References
- ¹ Children and young people’s mental health: policy and services (England) | House of Commons Library
- ⁵ Castillo EG, Ijadi-Maghsoodi R, Shadravan S, Moore E, Mensah MO 3rd, Docherty M, Aguilera Nunez MG, Barcelo N, Goodsmith N, Halpin LE, Morton I, Mango J, Montero AE, Rahmanian Koushkaki S, Bromley E, Chung B, Jones F, Gabrielian S, Gelberg L, Greenberg JM, Kalofonos I, Kataoka SH, Miranda J, Pincus HA, Zima BT, Wells KB. Community Interventions to Promote Mental Health and Social Equity. Curr Psychiatry Rep. 2019 Mar 29;21(5):35. doi: 10.1007/s11920-019-1017-0. PMID: 30927093; PMCID: PMC6440941.
- ⁶ The Community Mental Health Survey included young people aged 16 to 25 who accessed Child and Adolescent Mental Health Services (CAMHS).
