Mental health care unsafe, restrictive and ‘overly institutional in nature’

Mental health care regulators have today warned that the system is “at a crossroads” as there is currently too much poor care and too much variation in quality and access of services.

The safety of services was highlighted as particularly concerning, as well as the fact that many care facilities were “over restrictive and institutional in nature”.

Nationally, only 59% of NHS run services were rated as good for safety, with the figure rising slightly to 61% for independently-run services.

In its report looking into the state of mental health in England, the CQC said these problems were particularly concerning considering the high demand for services in the country.

It also said that patient clinical information systems were often not good enough, with many inspectors reporting difficulty retrieving and recording information related to patient care.

By 31 May this year, 68% of core services provided by the NHS and 72% of independent mental health providers were rated as good. But the CQC argued that this figure is not good enough, and that the quality of services is not up to scratch for too many patients in England.

“The mental health sector is at a crossroads,” said Dr Paul Lelliott, chief inspector of hospitals and lead for mental health at the CQC. “The Five Year Forward View for Mental Health, published last year, along with the newly introduced waiting time standards, point the way to a future where people have easy access to high quality care close to home and are able to exercise choice.

“To achieve this vision, the sector must overcome an unprecedented set of challenges – high demand, workforce shortages, unsuitable buildings and poor clinical information systems.”

Dr Lelliott also warned that many services were “rooted in the past” as care was restrictive and not catered to the individual’s needs.

“This can leave people feeling helpless and powerless,” he continued. “But the best services are looking to the future by working in partnership with the people whose care they deliver, empowering their staff and looking for opportunities to work with other parts of the health and care system.

“Those who deliver and commission care must learn from the services that are getting it right. And we will continue to highlight good practice, drive improvement and act on behalf of people to ensure that everyone gets the help they need when they need it.”

And Sean Duggan, the chief executive of the Mental Health Network, which is part of the NHS Confederation, said that an improved awareness of mental health brought with it increased pressure on already stretched services.

“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,” Duggan argued.

“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.”

The CEO also said that creating a strong and robust workforce needed to be a priority now in order to deliver necessary transformation to services.

“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,” he concluded.

Janet Davies, chief executive of the Royal College of Nursing, also said: “Despite promises of investment, there are 4,800 fewer mental health nurses under this government, which helps to explain why patients in some areas are being failed.

“Across the NHS, patient care deteriorates when the number of nurses drops. Without the right number of staff, mental health care will continue to lag behind physical health services.”

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