News extra

Mental health services need more talking therapy and care after hours

London Toby Reynolds

England’s community mental health services should widen patients’ access to talking therapies and information and provide better out of hours care, the Healthcare Commission said after a national review.

A survey conducted by the commission found that users were mostly satisfied with the service, with 77% rating their care as good, very good, or excellent and more than 80% saying that their psychiatrist and community psychiatric nurse had treated them with respect and dignity.

But less than half said they had a telephone number of someone from their local mental health service who could be contacted out of hours.

“The majority of people who suffer from mental illness receive their treatment in their own community, not in hospital,” said Anna Walker, chief executive of the regulatory body. “For care in the community to work for the mentally ill, more access is needed to talking therapies and out of hours crisis care. Mental health crises don’t keep office hours, and the service must be flexible enough to tackle this.”

The commission’s review comes ahead of a national report on community mental health that it will publish later this year. The review assessed all 174 local implementation teams in England against national standards for access of service, the range of needs catered for, and involvement of patients in decision making.

The commission rated 9% of local implementation teams as excellent and only 3% as weak. Nearly half (45%) were rated as good and 43% as fair.

The review also included the first national audit of the 2002 guideline on schizophrenia of the National Institute for Health and Clinical Excellence (NICE). The guideline says that psychological treatments, particularly cognitive behaviour therapy, should be available to those with the disorder, but the commission said that only 50% of people sampled had access to such therapy and that this percentage was much lower in a fifth of local teams.

The commission also said that management of drug treatment for schizophrenia had to improve. It found that 89% of services had not adequately recorded side effects or patients’ responses to the drugs, and overall it rated 84% of local teams in the worst two categories—weak or fair.

It also said that there was room for improvement in patients’ access to information. Only 5% of local teams received the commission’s top score for telling patients about possible side effects of drugs.

“It’s encouraging that most people have a good experience of the community practitioners that they see,” said Paul Farmer, chief executive of the mental health charity Mind. “But we’re concerned about the large number of people who don’t have access to basic treatments, like cognitive behaviour therapy, which is simply not available in many areas of the country.”

Nigel Edwards, director of policy at the NHS Confederation, which represents most NHS organisations and all its mental health trusts, said the report presented some serious challenges.

“The importance of talking therapies is not underestimated by the confederation’s mental health trust members,” he said. He added that results were awaited from pilot schemes in Newham and Doncaster launched earlier this year as part of a government programme to widen access to talking therapies.

“The service will be taking on board the commission’s recommendations on the availability of out of hours crisis services, as well as access to information,” he said.

Details of the national review of adult community mental health services are at www.healthcarecommission.org.uk.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?