A national report, published today by England’s care regulator the Care Quality Commission (CQC), confirms that adults with mental health complications are not receiving the same standard of care and support as those with a physical diagnosis.
Although these findings are not unexpected, the report goes further than previous studies in outlining exactly where service failures are to be found, criticising NHS trusts, clinical commissioning groups and local authorities for failing to work together on crisis care provision. While A&E services also come under scrutiny for a ‘lack of compassion and warmth’.
Deputy chief inspector of hospitals, Dr Paul Lelliott, calls for urgent change, saying, “It is not acceptable for people with mental health problems to be treated differently to those with physical health problems.
“We know that people can experience a mental health crisis at any time of day or night, and so the NHS and our other public services must make sure they are equipped to provide the specialist and urgent care that is needed around the clock. Sadly this is not what we have found from our national review.”
He continues, “What’s more, we found that when people do receive help, hospital and mental healthcare staff are not always compassionate and caring. Worryingly, many people told us that, when they were having a crisis, they often felt the police and ambulance crews were more caring and took their concerns more seriously than the medical and mental health professionals they encountered. In particular, people who have inflicted harm on themselves as a result of their mental distress deserve the same respect and compassion as those whose injuries are sustained by accident.”
According to the responses of adults who have experienced mental health issues, only 37 per cent of those who had to deal with A&E staff felt their concerns had been taken seriously, significantly less than the 86 per cent of those who had contacted charities or volunteer services.
As more than 68,800 people were admitted to mental health wards in England in 2013/14, these results highlight an alarming scale of failure on serious life and health-threatening issues, such as psychotic episode, panic attacks, extreme anxiety and suicidal behaviour.
Minister of State for Community and Social Care, Alistair Burt, comments, “We’re tackling historic underfunding and have increased investment in mental health by £300 million last year. We have also introduced the first treatment targets to make sure people get the prompt support they need and mental health is treated on the same terms as physical health. More people than ever before are receiving talking therapies, we are working hard to tackle mental health stigma, and work continues to improve early intervention services to make sure that people get the care they need to prevent crisis situations happening.
“Street triage schemes joining up police and nursing are proving to be successful and we have halved the number of people going through a mental health crisis going to police cells.
“Improving mental health care is my priority. I am clear that there is so much more to achieve and we all need to work together to achieve it. The CQC will now inspect crisis care arrangements in every service and I have asked them to continue to help stamp out poor care and help us to make sure that people with physical and mental health conditions are treated with equal importance.”
Chief executive of Mind, Paul Farmer, calls for professionals to wake-up, saying, “This report is a clear call to action. Mental health services are the victim of years of neglect and funding cuts over the last few years have taken their toll, at a time of rising demand. National and local commissioners must now make mental health a priority and invest in the future of our mental health services.
“We share the CQC’s optimism that the Crisis Care Concordat is a big opportunity to address the issues raised in this review. Every local area in England now has a detailed action plan for improving the support available for people in crisis, which has been signed by commissioners, NHS trusts, the police, local authorities and other services and agencies. It has been a huge piece of work getting to this point but in a way the work is just beginning. The challenge now is for every local area to deliver on their action plan so that everyone experiencing a mental health problem gets the help they need, when they need it.”
Brian Dow, director of External Affairs Rethink, agrees saying, “This report makes for painful reading, and seems to suggest an upside-down world in which patients feel they get the worst care where they should be getting the best.
“We need a more sympathetic response. Sympathy, understanding and good quality care when a patient walks in the door of A and E, and a sympathetic system where health and social care teams along with charities work in partnership to support the person properly after they are discharged.
“What would be unacceptable for physical illness should not be acceptable for mental illness.”
Dr Lelliott concludes by highlighting that the task should not be seen as a losing battle, saying, “We found some excellent examples of services in areas joining-up and providing effective care, with staff committed to working to make sure people in a crisis received the help they needed. These examples must become universal. This review was undertaken as part of CQC’s contribution to the work of the ‘crisis care concordat’ which is mobilising local services to come together to tackle this problem.”
“NHS trusts and other commissioners of care must make sure that they place a bigger focus on training staff to look after those having a mental health crisis, no matter where they are or when they need help. I feel that no NHS leaders can consider themselves to be a success while these issues go unanswered.”