Community mental health service review identifies gaps in out-of-hours crisis care

Mental Health Nursing,  Nov 2006  

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More people who use community mental health services say that NHS staff are treating them with dignity and respect, according to a national survey.

But improvements are needed in outof-hours crisis care, talking therapies and the amount of information given to people who use services.

These were the main messages from a major national survey of more than 19,000 people using mental health services provided in the community, which has been published by the Healthcare Commission.

The survey found that 77% of service users rated their overall standard of care as excellent, very good or good, while 9% rated their care as poor or very poor.

Most service users report being treated with respect and dignity by NHS staff, with community psychiatric nurses scoring more highly than their medical colleagues - 81% said they felt that their psychiatrist had definitely treated them with respect and dignity (up from 80% in 2005), while 86% said they felt their CPN had definitely treated them with respect and dignity (up from 85% in 2005).

The survey highlighted areas where progress needs to improve:

* Just 49% of service users reported having the phone number of someone from their local NHS mental health service who they could contact out of office hours (up from 48% in 2005)

* 62% of those calling an out-of-hours contact number said they had spoken to someone immediately, down from 64% in 2005. Only 21% got through in an hour or less (down from 22% in 2005)

* Talking therapy had been received by 39% of respondents (compared with 40% in 2005), with 35% of those who had not received counselling sessions saying they would have liked to have them

* More than half (52%) of those who received counselling, such as talking therapy, said they definitely found it helpful, the same percentage as last year's survey

Involvement of service users in decisions about their care is patchy. The survey found that:

* 42% of those who had taken medication to treat their mental health problems said that they had definitely been involved in decisions about this medication, up from 39% in 2005

* Every service user should have at least one care review a year to ensure that their care is appropriate for their current needs - yet only 51% of service users report having a care review in the last 12 months, although this is up from 47% in 2005

* 68% felt that they were definitely given the chance to express their views during their care review meeting, up from 66% in 2005. And 49% said they definitely found the review helpful, up from 47% in 2005

* Every service user should be offered a copy of their care plan, outlining their agreed programme of treatment. Some 45% of service users on the standard care programme said they had been offered a copy, up from 41% in 2005. This compared with 71% of those on the enhanced care programme for people with more acute needs, up from 70% in 2005.

* Less than half (48%) of respondents who wanted information about local support groups for mental health service users said they received it.

Anna Walker, chief executive of the Healthcare Commission, said: These survey results show that more people who use community mental health services feel they are being treated with dignity and respect, and this is good news.

'However, while many areas are showing improvements, there are clearly still issues that need to be dealt with.

'The majority of people who suffer from mental illness receive their treatment in their own community, not in hospital. They want to remain in the community and this helps them get better. But for care in the community to work for the mentally ill, more access is needed to talking therapies and out-of-hours crisis care.

'Mental health crisies don't keep office hours and the service must be flexible enough to deal with this.

'We will examine each trust's strengths and weaknesses in detail and will work with the NHS to use the survey results to drive improvement.'

Copyright Community Psychiatric Nurses Association Nov 2006
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