An important report has been published on the state of mental health in the UK - based upon the taskforce that has been working on it consulting widely with all the stakeholders in the system (except maybe those of us working in private practice who don't seem to have contributed much). This included a survey about changes people want to see, and most of the key points are not at all surprising.
The results of the survey, in order of perceived priorities are:
- Quicker access to mental health services
- Better choice of treatments
- More prevention
- Increased funding
- Tackle stigma and discrimination
- Least restrictive setting
- Improved workforce – skill mix and staffing
- Improved care planning
- Better parity of esteem (physical and mental health)
- More talking therapies
One of the key findings is that a greater choice of therapies, readily accessible, beyond limited CBT options, is what users want to see. This was how it was summarised in a Guardian article: "Leaked report reveals scale of crisis in England's mental health services"
You can find the full original report online here
From the Foreword
In March 2015 NHS England launched a Taskforce to develop a five-year strategy to improve mental health outcomes across the NHS, for people of all ages. Essentially, this will be a 'Mental Health Five Year Forward View' which clearly sets out how national bodies will work together between now and 2021 to help people have good mental health and make sure they can access evidence-based treatment rapidly when they need it. Collectively, we have a chance in a generation to deliver change that is achievable, urgent and necessary. This is an important opportunity to improve experiences and outcomes for people of all ages.
Our approach is one of co-production – involving people with lived experience of mental health problems, carers, professionals, providers, voluntary organisations and the component parts of the NHS – who are all part of the Taskforce. Our first step has been to find out what people want to see change, and this interim report reflects what they have shared and sets out what will happen next.
I have summarised the most important points from the report for those of us working in the private sector:
13. It was thought that much could be gained from a ‘community asset’ approach, particularly in working with community and voluntary sector organisations, including faith-based organisations, to equip people with knowledge and skills to understand and manage their own mental health and that of those close to them.
17. Timely access to effective, good quality evidence-based mental health treatment and therapies in response to need, always in the least restrictive setting, was a primary concern for the majority of survey respondents. Over half (52 per cent) of people said access is one of their top three priorities, and 33 per cent cite needing choice of treatment. 10 per cent specifically mentioned greater access to a range of psychological therapies in their top three priorities and wanted access and choice from a full range of evidence- based psychological therapies
19. Aspects of access raised through the survey included substantially reduced waiting times and an expansion of the choice of services to include a broader range of therapies for different types of mental health conditions. Some people stated a preference for being able to self-refer for treatment.
26. There was a clear call for support and interventions to always be provided in the least restrictive setting appropriate to meet a person’s needs, at any age. This was specifically cited by 15 per cent of survey respondents as a top priority. In engagement events, participants called for: provision of good quality home treatment; access to short stay crisis or recovery houses (where a person experiencing the onset of crisis can elect to stay in a respite setting providing intensive treatment and practical support); longer-term specialist residential services for those who need them (instead of long stays within secure inpatient services); and voluntary admission to inpatient care for those who need it, which is not always possible when thresholds for inpatient care are extremely high.
29. Survey respondents ranked different types of interventions in order of priority for improved access and quality. The top five areas people prioritised are:
- Early intervention;
- Psychological therapies;
- Home treatment;
- Information and skills to manage one’s own mental health; and
- Mental health awareness among the public;
30.People raised several aspects of the experience of being supported to respond to mental health problems. Of people citing choice as a top priority, 13 per cent described the importance of having the right information to make meaningful decisions about their treatment. Similarly, 13 per cent of people stated the need for wider diversity and skill mix in NHS staff, including the need for peer support and more staff with psychological support skills.
32. People expressed the need to have more control over their own care and to access the support that would work best for them as an individual, in line with the principle of ‘no decision about me, without me’. People reflected the view that, too often, care was ‘done to’ them rather than shaped with them and that health professionals did not systematically listen to them or take their concerns seriously.
35. People raised particular issues around medication, where many reported that they were not always given full information about potential side-effects, or were put on medication before other support options had been explored. Where people wanted to reduce or come off medication, they described a need for more support to be available to help them do so. There were calls for more research into the long-term effects of psychiatric medication.
39. People described wanting frontline staff across the NHS, including support staff, to have the confidence and skills to support people’s mental health needs. This included wanting staff to have the skills to work collaboratively to identify goals and plan care and treatment, and to involve carers appropriately and meaningfully. Developing a paid peer support workforce (people with lived experience) had considerable support.
42. There was support for greater regulation of non-NHS providers, particularly counsellors and psychotherapists, to protect people who use their services and ensure a high standard of care.
43. People described wanting a greater say in what services are available in their local area and how they are delivered, calling for services to promote wide- ranging and much more meaningful involvement with people who used services. People wanted to be paid for their time and expertise when helping to develop services, in recognition of the expertise they bring.