The report, The state of care in mental health services 2014 to 2017, highlights several areas of concern over the last three years. Among them are the growing number of detentions under section 136 of the Mental Health Act; more people being forced to accept out-of-area care; longer waiting times for specialist treatments; variation and persistence in the use of restraints; and physical environments not designed to keep people safe.
CQC inspectors found that there was too much poor care and far too much variation in both quality and access across different services. When coupled with rising demand, the CQC cautions, this puts more people are at risk of receiving care that is not good enough – or no care at all.
Despite these challenges, the report offered cause for optimism:
- Staff were seen as the greatest asset of mental health services. The care and compassion of NHS and independent staff were overwhelmingly found to be good or outstanding (NHS: 88% good, 9% outstanding; independent: 93% good, 5% outstanding).
- Overall, trusts and providers are improving. Almost three-quarters of NHS mental health trusts that were originally poorly rated had improved their rating by the time they were re-inspected.
- Mental health has never had a higher public profile. There is increased awareness and separate commitments from Government to improve care for children, reform the Mental Health Act, and provide the resources required to implement the Five Year Forward View.
- Staff and leadership from the most successful trusts are sharing ideas and working together with peers, helping the sector move closer to achieving the aspirations of the Five Year Forward View.
- Services provided by 54 NHS trusts and at 221 independent mental health locations were rated as part of the programme. The small number of specialist mental health services provided by NHS acute or community trusts was not included in the main analysis.
Responding to the report, Sean, chief executive of the Mental Health Network said:
“With improved awareness of mental health comes increased pressure on already stretched services and today’s CQC report makes for difficult reading. However it is important to recognise that this report covers three years of CQC inspections, with many pre-dating the hugely important work of the Mental Health Taskforce whose recommendations were published in 2016. The findings also highlight why the review of current mental health legislation is necessary and extremely timely in order to support staff and services to deliver safe and modern care.
“It is not all doom and gloom and there is much to celebrate from the achievements over the last year of the Five Year Forward View for Mental Health, with increased access to much needed psychological therapies and a significant focus on children and young people’s services.
“What we urgently need now is a strong and robust workforce fit for the future to help deliver necessary transformation. We await the upcoming workforce strategy and continue to press the Government to invest appropriately in mental health services. Getting mental health services right will relieve pressure on other parts of the health system.”