Intended for healthcare professionals

Practice Guidelines

Improving the experience of care for adults using NHS mental health services: summary of NICE guidance

BMJ 2012; 344 doi: (Published 01 March 2012) Cite this as: BMJ 2012;344:e1089
  1. Tim Kendall, director1, visiting professor2, consultant psychiatrist and medical director3,
  2. Mike J Crawford, professor in mental health research4, honorary consultant psychiatrist5,
  3. Clare Taylor, senior editor1,
  4. Craig Whittington, associate director (clinical effectiveness)6,
  5. Diana Rose, reader in user-led research and co-director7
  6. On behalf of the Guidance Development Group
  1. 1National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London E1 8AA, UK
  2. 2University College London (Clinical, Educational and Health Psychology), London WC1E 7HB
  3. 3Sheffield Health and Social Care NHS Foundation Trust, Sheffield S10 3TH, UK
  4. 4Imperial College London (Centre for Mental Health), London SW7 2AZ
  5. 5Central & North West London NHS Foundation Trust, London NW1 2PL
  6. 6National Collaborating Centre for Mental Health, University College London (Clinical, Educational and Health Psychology), London WC1E 7HB
  7. 7Service User Research Enterprise (SURE), Institute of Psychiatry, King’s College London, London SE5 8AF
  1. Correspondence to: T Kendall tim2.kendall{at}

Excellent service user experience is part of high quality healthcare, as well as a right and a necessity for all service users in the NHS.1 2 3 It is especially relevant for people with mental health problems, who often have repeated and/or prolonged contact with services, with nearly a quarter of adults meeting criteria for a diagnosis of mental disorder in England.4 Moreover, mental health problems are associated with considerable stigma in the health service, and users of mental health services, unlike any other health service users, can be detained and treated against their will under the Mental Health Act.5 National surveys of mental health service users show that, although most are satisfied with their care, a substantial minority have a poor experience of care and many report finding it difficult to access services especially during crises.6 Concerns have also been expressed about the quality of inpatient mental health services.7 This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on service users’ experience of adult mental health services; these recommendations come from the first NICE guidance for which a development group was chaired by a service user (jointly with a healthcare professional).8


NICE recommendations are based on systematic reviews of the best available evidence. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

Relationships, communication, and information provision

Work in partnership with people using mental health services and their families or carers, ensuring that you:

  • Offer help, treatment, and care in an atmosphere of hope and optimism

  • Take time to build trusting, supportive, empathic, and non-judgmental relationships

  • Foster autonomy, promote active participation in treatment decisions, and support …

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