Date Published: 12 September 2005

Mental health service users praise their care, but gaps still exist

Users of mental health services in England have praised the care they get from NHS doctors, nurses and other specialist staff, including psychologists and social workers, in a major national survey published today. However, the mental health patient survey, published by the Healthcare Commission, also highlights a number of areas where care could be improved, including better emergency support and better information on the side effects of medication.

The survey of 26,500 users of outpatient and community mental health services, found that 77% rated their overall care as excellent, very good or good. Less than one in ten rated their care as poor or very poor.

Most respondents (90%) have trust and confidence in their psychiatrist and an even greater percentage (93%) trust their community psychiatric nurse. There was also a slight increase since 2004 in the percentage of people saying that they were treated with respect and dignity (from 79% to 80%) and in the number who felt their psychiatrists listened to them carefully (from 68% to 69%).

However, the need for better access to crisis care was also highlighted by the survey, with 52% saying that they did not have the phone number of someone from local mental health services to contact in an emergency, despite guidelines in the National Service Framework (NSF) for Mental Health saying that they should.

The survey also found that only 40% had been given access to "talking therapies" such as counselling or psychotherapy in the last 12 months. This is despite strong evidence that a combination of drugs and psychological treatments can provide real benefits to people with mental health problems.

Questions are also raised by the survey about continuity of care. The majority (75%) of service users saw the same psychiatrist at their last two visits; one in four did not. Those who had seen the same psychiatrist on consecutive visits reported that they felt they were treated with more respect and dignity than those who were seen by different psychiatrists. Nearly half (44%) have had at least one appointment with a psychiatrist cancelled in the last 12 months.

A high percentage (79%) of those who responded to the survey are not in paid employment and almost half report being unable to work because they are too ill. Around half of respondent who wanted help to find work did not receive any.

Anna Walker, Chief Executive of the Healthcare Commission, said:

" This survey shows people who use mental health service have a lot of praise for the doctors, nurses and other specialist staff providing their care. The survey shows some improvement across the board and its good to see that the service is moving in the right direction.
_
However, there are still problems that need to be addressed. Service users need better support and information, especially out of hours. They need more access to counselling and they need better continuity care. These are important challenges patients have set for the service and they need to be addressed. It is also important that we do all we can to support service users who want help back to work.
_ The Healthcare Commission will be examining individual trust's results in great detail and using the information to share best practice and drive improvement. This survey of mental health service users is part of our determined effort to shine a light on an important, and often neglected, part of health care
."

Service users were asked about the communication they had received as part of the survey. Seventy-five percent of those who responded to the survey who had been sectioned said they had had their rights explained to them; one in four said they had not. Also, although most of those who responded to the survey (93%) have taken medication for their illness over the last year, 35% said that the possible side effects of the medication were not discussed with them. 81% said they had been involved in deciding what medication they should take.

The National Service Framework for Mental Health states that all those using mental health services should have agreed a care plan with their mental health provider, which outlines their assessment and how care will be provided. The survey found that almost one in four had not been involved in deciding what was in their care plan and over half said they had not had their care plan reviewed in the last six months. Over half (59%) of people on the standard care programme approach (CPA) had not been given or offered a written copy of their care plan, while 70% of those on enhanced CPA (for people with more acute needs) had been offered or received a copy of their plan.

Source(s): The Healthcare Commission (England, UK),
formerly at http://www.healthcarecommission.org.uk - website no-longer live.

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