An introduction to Dr Arun Chopra and reflections on the power of community in mental health care
In his first blog as CQC’s Chief Inspector of Mental Health Dr Arun Chopra discusses his career so far, and reflects on the importance of community in mental health care.
I’m excited to be joining CQC as the first Chief Inspector of Mental Health, particularly at such a significant time for the organisation as it looks to refocus on its core purpose and rebuild confidence. As a mental health professional, I have spent my career working to improve care for people who use mental health services. I have worked on the front line in clinical psychiatry, in protecting and promoting the human rights of people with a learning disability, mental illness, dementia and related conditions at the Mental Welfare Commission for Scotland, and I have contributed to mental health law reform for England, Wales and Scotland. I’m now really looking forward to getting started in my new role, working with colleagues and stakeholders to support mental health services to provide good, safe, person-centred care that helps people to recover.
This week is Mental Health Awareness week, and the theme for 2025 is the power and importance of community. In a broad sense, being part of positive communities is important for our sense of wellbeing and mental health. Specifically, within the context of mental illness, services based in community settings are where so much of the work takes place to support recovery and prevent relapses from illness. I’ve been learning about the work that has been taking place at CQC around community mental health services and I’m looking forward to contributing this. As part of our work in mental health, it is important to support improvements to the pathways of care that people experience so that this care is joined up and not fragmented.
We all know that community mental health services are struggling to meet increasing need. A 2024 British Medical Association report shows that there has been a 33% rise in referrals to mental health services since 2019. The results of our 2024 Community mental health survey, published in April, highlighted the issues that people trying to access services are facing. The results of the survey, informed by feedback from over 14,000 people, continue to show that some people are not able to access care when they need it. There were some areas of positive results, such as support to access care or treatment, medication, and privacy of care settings. However, crisis care provision, support while waiting for care, as well as support with other areas of life, are highlighted as key areas for improvement. On planning and involvement, it was disappointing that over a third of people said that they did not have a care plan; and a similar proportion had not been involved in choices about how care was delivered.
The survey also continues to show how experiences vary for different groups. For example, while older people were generally more positive about their interactions with their mental health team, children and young people and autistic people reported poorer experiences across multiple areas of care.
Similarly to the community survey results, our most recent State of Care report showed how high demand for community health services, and the inability to meet that demand, continues to affect people’s ability to get the help they need, when they need it. This can lead to people presenting with urgent and emergency care needs. Research commissioned by CQC into mental health attendances at urgent and emergency care found that people aged 18 to 21 consistently have the highest rates of presentation for mental health issues at both emergency departments and urgent care centres. These findings illustrate the importance of a pathway approach and how community-based intervention with a shared care plan and good crisis planning can impact on presentations in emergencies.
Further downstream, as highlighted in this year’s Monitoring the Mental Health Act in 2023/24, we are concerned that the system is at risk of failing some of the most vulnerable people in need of care, their families and in some cases, the wider society. The report also noted that many services told us that patients seem to be more unwell on admission than in the past, again pointing to a lack of supportive interventions earlier. We have heard this in relation to admissions from the community, as well as transfers to hospital from prisons. Following admissions, we know that there are racial disparities in the use of community-based treatment orders which can then further impact on trust and access to earlier care. We’ll be closely monitoring the Mental Health Bill 2025 as it progresses through Parliament as there are provisions in this which aim to improve the rights of people who experience compulsion.
In 2024, the Secretary of State for Health and Social Care commissioned CQC to carry out a rapid review of Nottinghamshire Healthcare NHS Foundation Trust (NHFT) following Valdo Calocane’s conviction for the killings of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber. The review, which focused on the quality and safety of mental health services at NHFT, also found systemic issues with community mental health care. It highlighted the need to look more closely at community mental health services nationally to fully understand the gaps in quality of care, patient safety, public safety, and staff experience in community mental health services.
Following the publication of this report, CQC started a comprehensive programme of inspections of community mental health services for working age adults and crisis services. Since March 2025, we have visited a number of trusts and have completed assessments of their community services and their crisis services.
To help shape our inspections, we held sessions with people who had experienced adult community mental health services and people that work in trusts providing these services. We heard clearly the desire for improvement in these services and the unique role CQC should have in identifying where we see good care, sharing innovative practice, and highlighting areas that must improve. Providers were particularly interested in discussing the way CQC can highlight system pressures and help different partners work together across primary and secondary care to ensure people are kept safe. I am really looking forward to working with colleagues and stakeholders to contribute to this work.
