Community based mental health services are seeing fewer mental health patients despite a rise in demand and more people are being detained under the Mental Health Act.

  • HSCIC data shows 21 million contacts with patients in community based mental health services last year
  • Decrease comes despite overall rise in people in contact with mental health services
  • Concerns about increasing use of detentions under Mental Health Act

According to the latest annual data from the Health and Social Care Information Centre, 12 types of community based service, including crisis resolution and home treatment teams, saw a fall in the numbers of contacts with NHS patients during 2014-15.

There were 21 million contacts with patients, a drop of 671,408 from the previous year, despite the overall number of people in contact with mental health services increasing by 5 per cent.

The HSCIC today provided a breakdown of changes to community mental health services to HSJ, following the annual data release last week.

The largest decrease was in day care services, which fell by 41 per cent compared with 2013-14, or more than 200,000 contacts. Other community services experiencing reductions included:

  • crisis resolution and home treatments teams, down by 109,000 (6 per cent);
  • general psychiatry, down 328,000 (16 per cent);
  • Improving Access to Psychological Therapies services, down 72,000 (37 per cent);
  • forensic services, down 40,000 (13 per cent); and
  • assertive outreach teams, down 153,000 (21 per cent).

Analysis by the HSCIC showed the number of mental health patients detained under the Mental Health Act rose by almost 10 per cent year on year in 2014-15 to 58,400 – the third successive year of a rise in the number of detentions.

Mental health

The number of patient contacts with crisis resolution and home treatments teams fell by 109,000

The number of detentions in NHS hospitals increased by 4,000, or 8 per cent, to 51,970 and in the independent sector by 25 per cent to 6,430.

Overall there were 1.8m people in contact with mental health services during the year, with 103,840 spending time in hospital – a small fall compared to the 105,270 a year before.

The reductions in community services contacts have prompted fears some services that can help reduce acute demand are being scaled back amid financial cuts, despite the government’s policy of achieving parity of esteem between physical and mental health care.

Andy Bell, deputy chief executive of the Centre for Mental Health, told HSJ the data was concerning.

He said: “We are seeing positive investment in things that we know work but unfortunately at the same time we are seeing some other things that are very valuable, such as crisis resolution and home treatment, being scaled back. That is particularly concerning in the context of a rise in the use of the Mental Health Act. We should be very concerned about those two changes in combination because the [act] needs to be used only when necessary.”

He added: “It’s much harder in mental health to make efficiencies and it’s inevitable with the kind of [financial] squeeze we have seen that some very valuable services will be reducing their activity levels. The risk is that not intervening earlier when people need help creates bigger problems for them and for the service later on.

“What we know about spending would suggest that we are going in the wrong direction on parity in as much as mental health spending has been going down during the last parliament.”

A Department of Health spokesman said: “Overall, patients say they have a good experience of mental health services but there are areas where trusts need to improve further. Since the time of this survey, areas across the country have started introducing our groundbreaking access and waiting time standards for mental health which will help drive local investment and improve services.”