NHS mental health system failing staff and patients, warns Mind, as survey reveals widespread concerns over quality of care
Mind, the mental health charity, is calling on the UK government for an overhaul of the mental health system in England so that people can talk to a mental health professional when they reach out for help.
The charity has today published their Opening Doors report setting out the changes needed to radically improve support for people with mental health problems and better equip mental health professionals to provide this. With ever-growing NHS waiting lists for mental health support and worrying numbers of people ending up in A&E, Mind is urgently calling for England to follow the lead of Wales, which has already committed to a ‘same-day open access’ model of mental health support. This comes at a time when mental health is at a pivotal moment, with a planned cross-governmental mental health strategy on the horizon.
How it works
The same-day open access model works like this:
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Reaching out for help is met with an immediate, meaningful response, not a waiting list or a referral into an opaque pathway.
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The first interaction a person has in this system is a conversation with a professional where they take the time to properly understand the person’s needs and circumstances.
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This conversation is the foundation for identifying the right support. That might be clinical care, peer support, help with housing or employment, or a combination of these.
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Some of our local Minds have already started implementing open access services. Doncaster Mind, for example, now has a single point of access for all referrals, enquiries and self-referrals into Doncaster Mind. People who contact them are supported to access the most appropriate pathway or service for their needs.
Far from driving unnecessary demand for services, the same-day open access model would direct people to the right support first time. By alleviating distress and better identifying and addressing needs earlier, it prevents people’s mental health from deteriorating, reduces pressure on clinical and acute services, and helps individuals to move towards recovery or living well with mental illness.
Addressing historic underfunding and workforce shortages will be critical to transforming our mental health system, but at the core is a need to rethink how people access support.
Zarah Khalique, 23, from Leeds, struggled to access treatment under the current system for an eating disorder and anxiety. She said:
“I initially waited a year and a half before accessing my first treatment which was both challenging and not unique. Seeking mental health support takes courage, and long waiting lists are a disheartening response to that.
“This approach feels groundbreaking. I know personally that the most effective support that I received was from a professional who had a personal understanding of my cultural background and the nuanced factors influencing my experiences of mental illness at the time.
“This model would have benefitted me when seeking mental health support for the first time. It feels much more empowering for the service user with support being direct, relevant and meaningful.”
Why now?
The call comes as a new survey reveals that under the current system, many NHS professionals do not feel able to deliver the quality-of-care people need.
Mind surveyed almost 800 NHS mental health professionals and found that over a third (34%) did not feel able to consistently deliver the standard of care that people need. Close to half (42%) said their ability to deliver high-quality care has got worse over the past 12 months. One Mental Health Nurse shared that, “It often feels like firefighting. I get so upset that I do not have the resources available to provide the care, support and treatment that is needed.”
When asked about a range of factors that may be impacting on the quality of care they can provide:
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Three quarters (75%) of respondents cited inadequate staffing levels
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Nearly three quarters (71%) pointed to high caseloads.
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Over two thirds (69%) identified people presenting with more complex or acute problems.
Tom Pollard, Head of Policy, Public Affairs and Campaigns, said:
“Tightly gatekept and rationed services are not managing demand; they are exacerbating it. Many people find themselves stuck on long waiting lists or bounced between different services, while their mental health problems become worse and the impacts on their lives become more entrenched.
“It is clear the current system is unable to provide the quality of care needed and requires fundamental reform. People should be able to talk to a mental health professional on the day they need it. Equally, professionals should have the time to make someone feel heard and understood, and to identify the immediate and longer-term support they need.
“Mental health is at a pivotal moment, with a planned cross-governmental mental health strategy on the horizon. We have already seen some initial, positive steps in England towards a ‘same-day open access’ model of support. Similar to Wales, the UK Government needs to now seize the opportunity to build on this by committing to system-wide reform in its upcoming strategy.”
Andrew Hughes, a Social Worker in London who is speaking in a personal capacity, added:
"Social Work can be incredibly stressful and demanding. Like many professions centred on supporting those in need, on a daily basis we face high caseloads, a diverse range of mental health and social issues, a lack of resources, and pressure to quantify care into outcomes and targets.
“We work within a set of systems and processes that are often siloed and inefficient and, without meaning to, actively create barriers for frontline staff to provide care. There is a huge need for compassionate, person-centred, practical and assertive support for an increasing number of people facing challenges with their mental health.”
