Community mental health teams need to do more to improve their services, the Care Quality Commission’s (CQC) deputy chief inspector of hospitals (lead for mental health) has warned.
The warning comes after the publication of the results a survey of more than 13,500 people who use community mental health services in England. The survey asked for views from people who receive community mental health services and included people receiving services under the Care Programme Approach (CPA) – where people require support from more than one professional or team, and may require support for other areas of life, such as employment or housing.
While the survey found that the majority of staff providing community services ‘definitely’ listened carefully to people receiving services (73%) and ‘always’ treated them with respect and dignity (75%) it also highlighted serious problems with other aspects of care, suggesting that services are not engaging as they should with service users.
For instance, 20% did not feel they have seen staff from the mental health services often enough to meet their needs, 23% had not been told who is in charge of their care, 23% had not agreed with someone from mental health services what care they will receive and 26% had not had a formal meeting to discuss how their care is working in the last year.
Dr Paul Lelliott, the CQC’s deputy chief inspector of hospitals (lead for mental health) said: “It is clear from this survey that many people do not feel well-served by community mental health services. Leaders and staff from mental health trusts should reflect on what they could do differently and better to ensure people are engaged effectively and involved in their care and take action to ensure that people get the help and support they need.
“We have raised this before with mental health trusts, including following last year’s survey. The survey will inform our decisions about when how soon we inspect a trust. We will soon start to rate these mental health services and how well they have responded to the results of this survey will play a part in determining our overall judgment of trusts.”
Involvement in mental health services
Where appropriate, involvement in care and treatment decisions should extend to families and carers. But the findings found that only 55% of people said that NHS mental health services ‘definitely’ involved their family or someone close to them.
Also of concern to the CQC is that almost 1 in 3 people (32%) did not know who to contact out of hours if they have a crisis. Where people did know who to contact and contacted them, 20% of respondents did not get the help they needed.
There was also evidence of poor communication in regard to medication. Only 53% of people prescribed new medicines for their mental health needs saying that they were ‘definitely’ given information about it in a way they could understand.
Central to people’s recovery is that they should be able to build a meaningful life for themselves, and be supported to take control of and manage their own condition. But only 43% of respondents felt that the staff they see ‘always’ understand what is important to them in their life; ‘always’ help them with what is important to them (42%); and ‘always’ help them to feel hopeful about the things that are important to them (39%).
People receiving care under CPA should also receive help or advice with finding support with employment, housing and finance from mental health services, if they need it. Of those who were under CPA and said they needed this support around a third of respondents would have liked more help or advice with finding support with financial advice or benefits (32%) finding or keeping work (34%) and finding or keeping accommodation (31%).
Trusts need to do more to ensure people are given help or advice to find support for these other areas of life where this is needed. Supporting people’s wider needs such as housing and finance can greatly aid recovery and these matters should not be treated by healthcare professionals as an optional extra but as fundamental part of helping people on the road to recovery.