Exploring our Community mental health survey results
In this new blog Chris Dzikiti, Director of Mental Health, explores the results of the recently published Community mental health survey, focusing on new insights on child and adolescent mental health services.
Last month we published the results of our 2023 Community mental health survey, which has been running annually since 2004. As this week is Mental Health Awareness Week, I wanted to take this opportunity to explore some of the survey findings in more detail.
This year, the survey saw significant redevelopment to the methodology and eligibility, as well as the content of the questionnaire. For the first time people could complete the survey online as well as a paper version. One of the biggest changes though, is that this year the age of participants was lowered to include 16- and 17-year-olds. This is a huge step, as we have been able to collect data from people using child and adolescent mental health services in this way for the first time. Gathering this data is hugely beneficial to driving improvement in this part of the sector, where we know already there are significant issues.
In our 2022/23 Monitoring the Mental Health Act report, we highlighted that rising demand and a lack of community support means that children and young people continue to face long waits for mental health support. The Community mental health survey showed the stark reality of this, painting a concerning picture of child and adolescent mental health services. Overall, people using child and adolescent mental health services are having worse experiences across most areas of care that we cover in the questionnaire. The most prominent areas being access, quality of care, and crisis care.
We know that access to mental health care is a widespread issue, but the survey shows that it is particularly poor for people seeking support from child and adolescent mental health services. Overall, only 25% of people said they were given the help they needed from child and adolescent mental health services. This is a shocking and saddening statistic, particularly when coupled with the fact that 24% of respondents said they waited for 6 months or more between their first assessment and their first appointment for treatment. Young people are waiting too long for treatment and are not offered enough — or any — support while they wait. When they do access care the quality is not good enough and 41% of respondents said they had to repeat their mental health history often.
When it comes to crisis care, only 2 in 5 (38%) of those who responded knew who to contact out of office hours if they were in a mental health crisis. Of those who did contact crisis care services, 40% said they didn’t get the help they needed the last time they contacted them, and 26% of respondents said it took them too long to get through to the crisis team.
Clearly the picture here is far from what we want to see, but we are grateful to have this data which we have not had before from the survey. We’ll use the results from the survey to continue to build our understanding of the community mental health landscape, and to inform our targeted assessment activity. NHS England are also well aware of the issues in this part of the sector — the NHS Long Term Plan aims to embed support for children and young people in schools and colleges, and new NHS-funded mental health support teams working in educational settings should be rolled out to between one-fifth and a quarter of the country by the end of 2023. NHS England have also provided funding for a Mental Health Champion in in every provider that admits children from autumn 2023. The champions role is to advocate for children’s mental health, facilitate greater join-up between physical and mental health teams, and work strategically in their department and Trust. With crisis care being an area where we have seen poor results in the survey, this can only improve matters.
Integrated care systems (ICSs), working with their partners, are taking steps to improve community services, as set out in the Mental Health Implementation Plan including working towards 100% coverage of 24/7 crisis provision for children and young people by 2023/24. This video explains more about how NHS England are working to improve services for children and young people.
The results will also feed into future projects like our annual monitoring of the Mental Health Act report and will help us to see where we can work with the system to drive change and improve care for those who need it. Improving regulation for children inappropriately placed is one of our key priorities and links to the findings in our Mental Health Annual Report, where we talked about the high demand and lack of specialist beds in services for children and young people means that those with mental health needs continue to be cared for in inappropriate settings. Our work to address this aims to identify what CQC can do, internally and externally, to prevent children being cared for by providers who cannot meet their needs, reduce their risks of being exposed to poor quality care and ensure the following positive outcomes are achieved for all children.
I hope that in future years we will be able to report on more positive findings and can see where improvements are being made.
