National Service Framework five years on
Posted Thursday 30 September 2004
Five years on - Progress on the National Service Framework for Mental Health proves patchy at best.
Mind, the leading mental health charity in England and Wales, has reviewed the progress of the National Service Framework (NSF) for Mental Health as it celebrates its fifth anniversary. Mind has found that the comprehensive plan to improve mental health services needs major acceleration if the aspirations of the framework are to be met.
In 1999 the Government set out the NSF programme, which laid down models of treatment and care which people would be entitled to expect in every part of the country. Five years on, Mind believes the NSF has made some improvements, although other equally important areas are still not being met. The charity is concerned that the national standards it sets out will not be met in the ten year time frame if the Government fails to address the progress of the framework with more urgency.
The NSF for Mental Health was set in five areas to improve all aspects of mental health care and treatment. However Mind has identified unsatisfactory progress in six of seven standards.
Standard one - Mental health promotion
In the five years since the publication of NSFMH, progress is limited, very little implementation of mental health promotion has been achieved in many areas of the country. A national commitment is needed in order to create a more mentally healthy environment. Mental health services still need to develop and demonstrate cultural competence, staff must have the knowledge and the skills to work effectively with diverse communities.
Standard two and three - Primary care and access to services
Further work needs to be done before it can be claimed either of these standards are being met.
A large number of service users still do not have adequate access to primary care services. Most GPs and primary care staff still have no significant formal training in mental health.
Standards four and five - Effective services for people with severe mental illness
Although a great deal of emphasis has been placed in the last five years on the development of community based services, and for a large number of people this has resulted in improvements. However the services such as Assertive outreach teams are still not available to all. In addition, Mind is concerned that current proposals under the Mental Health Bill for compulsory treatment in the community will undermine the crucial relationship of trust upon which assertive outreach is based and may threaten the realisation of both standards four and five.
Last month Mind published the Ward Watch report after consulting four hundred service users who had used in-patient hospital services during the last two years. The report identified some mixed examples of inpatient care and highlighted particular concerns regarding mixed sex wards, safety issues and a lack of meaningful activity for those in hospital for a prolonged amount of time. The services provided to people in hospital remain in need of significant improvement.
Standard six - Caring about carers
We have not commented on carers issues as this is not a key theme of Mind’s work.
Standard seven - Suicide prevention
Preventing suicides by meeting Standards One to Six.
If all previous standards were fully implemented, particularly with reference to mental health promotion but also primary and secondary care services, much progress toward suicide prevention would be made.
Sophie Corlett, Policy Director at Mind, said:
"The NSF laid out a comprehensive plan to improve mental health services in England and Wales. If achieved it would deliver better care and treatment for around one in six of the population. Progress to date is unsatisfactory and calls into question the Government’s stated prioritising of mental health.
"Our Ward Watch campaign, launched earlier this month has already highlighted failings in delivering improvements to conditions in psychiatric inpatient units. While the Government has ensured good practice and excellent service delivery in some areas, standards must be met right across the board."
Mind found 416 current or recent mental health inpatients to take part in the Ward Watch research. Recent is defined as patients who at the time they contributed to the research had been inpatients in the past two years.
The Ward Watch report launched by Mind on 7 September 2004 highlighted a number of shortcomings in the implementation of the standards and found that:
- Two years after the Government’s own target for the elimination of mixed sex wards and less than a year after it claimed that 99 per cent of the NHS Trusts met Government targets, 23 per cent of recent or current inpatients have been accommodated in mixed sex wards.
- A staggering 51 per cent of recent or current inpatients reported being verbally or physically threatened during their stay in hospital. Only 44 per cent of respondents felt safe all or most of the time.
For further information on the National Service Framework for Mental Health please consult the Department of Health website www.dh.gov.uk