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Community mental health services failing many users

Huge CQC survey finds much satisfaction but large gaps in care

Louise Prime

Wednesday, 15 September 2010

People using community mental health services generally said they felt listened to and respected, but half didn’t know whom to contact in an out-of-hours crisis and many said they had insufficient understanding of their care, a survey by the Care Quality Commission (CQC) has shown. The report also reveals a gap between provision of talking therapies and patients’ desire for them.

The CQC has published the views of 17,000 adults who used specialist community mental health services – psychiatric outpatient clinic, local community mental health team or other community-based service – from July-September 2009. The survey covered 66 NHS trusts.

Most service users (88%) said they were treated with respect and dignity, four in five (80%) said that their health and social care workers listened carefully to them, and nearly three-quarters (73%) said they were given enough time to discuss their condition and treatment. A similar proportion (72%) said they trusted and had confidence in their health or social care worker.

However, many people said they felt insufficiently involved in their own care and had not been given adequate explanations of their treatment. Fewer than half (43%) of those prescribed new drugs in the past year claimed to have ‘definitely’ been told about possible side-effects of their new drugs and 29% said they were not told at all.

Fewer than half (48%) of patients said they ‘definitely’ understood what was in their care plan, 29% understood it ‘to some extent’, 15% were not sure and 9% did not understand it. Only just over half (57%) had had a meeting to review their care plan in the past year and only 44% knew the phone number for an out-of-hours mental health problem.

Of the patients who said they wanted a form of talking therapy, more than a quarter (27%) had not received it.

The survey also revealed large-scale unmet need for help dealing with people’s physical health problems and social problems such as finding and keeping employment or accommodation and claiming state benefits.

Cynthia Bower, CQC Chief Executive, said: “There is no doubt that the added investment and attention over recent years has improved the quality of community mental health services. There are some very positive messages from service users, particularly about health and social care workers. Theirs is no easy job, so these results are a tribute to them.

“But the results also suggest that in some respects the care offered … is falling short of meeting the range of needs that they have. We know that involving people in their own care and ensuring they understand their treatment, helps people to get better faster. Yet these are the areas that need the most improvement.

“It is important that trusts look at the survey results carefully and consider whether, firstly, they are assessing people’s needs properly in the context of the CPA [Care Programme Approach] policy, and secondly, whether they are giving them the appropriate level of support.”

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