Care Quality Commission survey of mental health service users
Survey of people who use community mental health services will help to assess changes in experience of care
The results of the 2011 survey of people who use community mental health services, published today (9 August) by the Care Quality Commission, are set to play an important role in the Government’s new mental health outcomes strategy.
The experiences of more than 17,000 service users across the 65 NHS mental health trusts in England are reflected in the survey, which asked them questions about their care during the past 12 months.
They received care and support from mental health services outside hospital, such as those offered by outpatient clinics and local teams providing crisis home treatment, assertive outreach, early intervention for psychosis, and generic community mental health services.
Cynthia Bower, Care Quality Commission (CQC) chief executive, said: “The new cross-government strategy for mental health outcomes, No health without mental health, was launched in February. One of its overall aims is to improve outcomes for people through high-quality services that are accessible to all.
“The results of the community mental health survey this year and in the future have been identified in the strategy as one of the key sources of information to assess progress in improving people’s experience of care and support.
“I think it’s fair to say that those who took part in this year’s survey were positive about some aspects of the services they received but many found that some of their needs were not fully met.
“I know we are entering a period when resources may be stretched even further than they have been before. But I urge all those who provide community mental health services to strive to maintain, and where possible raise, the levels of care. I also call on commissioners of services to study the survey results and use the levers that are available to them to improve outcomes for people who use these services.”
Ms Bower pointed out that the large majority – 86% – of those who took part in the survey had not spent any time in hospital during the past 12 months, which underlined the importance of mental health services in the community. Such services are the main source of specialist support for around a million people each year across England.
The results of the 2011 community mental health survey suggest there is scope for involving people more in aspects of their care, such as care planning and medication. For instance, less than half said they “definitely” understood their care plan, while more than a quarter of those who were prescribed new medication said they were not told about the possible side effects.
One of the specific objectives of the national mental health strategy is to ensure that more people with mental health problems enjoy good physical health. Of those with physical health needs who responded to the survey, many said they would have liked more help. Thirty-five per cent had “definitely” received support in getting help with their physical health needs and 34% had “to some extent”. But 31% said they had not received any support, although they would have liked it.
The national strategy places a strong emphasis on early intervention – through identification and referral by GPs – linked with expanding people’s access to psychological therapies such as talking therapies. Thirty-nine per cent of those who responded to the survey had received talking therapy during the past year, but 47% said their mental health or social care worker had not discussed talking therapy with them in the past 12 months.
Where they can be compared with last year’s results, the responses to the 2011 survey showed that:
· most people again responded positively to questions about the health or social care worker they saw most recently, saying they took time to discuss their condition and treatment with them, took their views into account and treated them with respect and dignity;
· there were improvements in aspects of crisis care, with more service users this year saying they had the number of someone to call in their local NHS mental health team outside office hours – increasing from 56% in 2010 to 58%. Of those who called the number, 16% did not get the help they needed, but that was better than the 19% in last year’s survey;
· there was a less positive response when those surveyed were asked if NHS mental health services had involved a member of their family, or someone close to them, as much as they would like. Forty-nine per cent said they had “definitely” been involved as much as they would like, compared with 52% in 2010.
People who have complex mental health needs and require multi-agency support are cared for within a framework called the Care Programme Approach (CPA). For service users who are not on the CPA, the focus is mainly on addressing their clinical needs, whereas policy guidance states that people who are on the CPA should also receive support with day-to-day matters such as employment, housing and financial advice.
Forty-two per cent of respondents to the survey were on the CPA. Of those who were on the CPA and said they needed support with day-to-day living:
· 35% said they had not received help from anyone in NHS mental health services in the past year with finding or keeping work, such as being referred to an employment scheme, although they would have liked some support;
· 27% said they had received no help with finding or keeping their accommodation, although they would have liked some;
· and 27% said they had not been given any help with financial advice or benefits, although again they would have liked support.
Service users who are on the CPA should receive a formal review of their care at least once a year. In the past year, 40% of respondents on CPA said they had had more than one review, 33% had received one and 26% had not had a review at all.