Mental health service users continue to report gaps in access to care, support for wellbeing and continuity of care

The results are in for the most recent annual survey of people’s experiences of NHS community mental health services: the largest survey of its kind in the UK. The results offer a powerful insight into how people really felt about the care they received.

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The results are in for the most recent annual survey of people’s experiences of NHS community mental health services: the largest survey of its kind in the UK. The results offer a powerful insight into how people really felt about the care they received.

The 2017 national survey received responses from more than 12,000 people age 18 and older who had used services at one of the 56 NHS mental health trusts between 1st September and 30th November 2016.

Findings from the survey indicated major issues with access to care, continuity of care and support for wellbeing, though two thirds (65%) of service users rated their experiences favourably.

Many areas of care were found to be in need of improvement. Under half of respondents (44%) said they had ‘definitely’ seen NHS mental health services enough to meet their needs. This figure has worsened by 3% points since 2014.

Access to crisis care was also a major issue. Although 71% of respondents knew who to contact during an out-of-hours crisis*, 26% of those who tried to contact somebody did not get the help they needed.  This has worsened by 5% points since 2014.

Another concern was continuity of care, an important element of people’s relationships with healthcare staff. Forty two percent of respondents stated they experienced changes to the people who provided their care**.  Of these:

  • 47% did not know who was in charge of organising their care during that period of change
  • 23% said the reasons for the changes were not explained at the time
  • 31% reported that the impact of this was that their care got worse.


Chris Graham, Chief Executive of Picker, commented:

“Many mental health conditions require support over a period of time. As outlined in the Picker Principles of Person Centred Care, service users value opportunities to develop therapeutic relationships with trusted professionals, and it is equally important that they are able to access urgent care and support when they need it most.  Results show that too many users were adversely impacted by changes to the people they see.  It is also concerning that a sizeable minority were not able to get the care they needed when in a crisis.”


Person centred care requires a holistic approach to supporting and improving the wellbeing of users.  Unfortunately, a large proportion of respondents said they did not adequately receive the vital support that they wanted. For instance, nearly half of all respondents who wanted help with finding support for financial advice (45%) did not receive it.  Similarly, 49% of people who would have liked help and advice finding peer support did not receive it. These negative findings have failed to improve since 2014.

Despite this, some positive experiences were apparent from the survey.  Of the 76% who agreed on what care they would receive with somebody from NHS mental health services, 93% felt their personal circumstances were taken into account.  Furthermore, 82% said the people they saw helped them with what was important to them.  Eighty percent of people said that someone close to them, such as a family member, was involved as much as they wanted them to be.

Chris Graham concluded that:

“Today’s results highlight the experiences of people using mental health services, and we are grateful to the 12,000 respondents for sharing their views.  They paint a picture of a service under pressure and users struggling, at times, to access the support they need.  This is perhaps unsurprising given that demand for mental health services is increasing whilst many providers report shortfalls in staffing and difficulties in fulfilling their obligations within existing budgets.  In spite of the challenges faced by providers, person centred care must remain the number one priority of mental health services and we urge all providers to review their detailed survey results.”

The survey results can be viewed here:

As a recognised and respected not-for-profit organisation, Picker is dedicated to understanding and improving patient experiences and utilising the results to influence policy and practice to achieve high quality care for everyone, always. To do this, Picker advocates eight key principles of person centred care:

  • fast access to reliable health advice
  • effective treatment delivered by trusted professionals
  • continuity of care and smooth transitions
  • involvement and support for family and carers
  • clear, comprehensible information and support for self-care
  • involvement in decisions and respect for preferences
  • emotional support, empathy and respect
  • attention to physical and environmental needs

These principles allow service users to experience the best possible care and high quality interactions with health care services which is known to improve clinical outcomes and patient wellbeing.

* A crisis is if you need urgent help because your mental or emotional state is getting worse very quickly.

** This excludes changes made that were requested from the service user and changes due to moving home.