Background
Understanding what community mental health care is like for service users provides key information about the quality of services across England. The NHS Long Term Plan and the NHS Mental Health Implementation Plan both committed to bettering the quality of community mental health care, financed by an additional £I billion to the Long Term Plan fund each year until 2023/24. The NHS Constitution commits the NHS to encourage patients to give feedback on their experiences and to use this to improve services. The Community Mental Health Survey asks a sample of service users from each trust several questions about their experiences, the responses to which we explore here.
The Community Mental Health Survey asks service users to rate their overall experience from 0 (very poor) to 10 (very good). There have been small fluctuations in service users’ overall experience from 2017 to 2021. Due to methodological changes, the 2023 survey results and onwards are not comparable with previous years’ results – for more information, visit the ‘About this data’ section. In 2024, 48% of service users rated their overall experience as 8, 9 or 10 and 15% rated their experience as 0, 1 or 2.
In comparison with other national patient surveys, community mental health service users rated their overall experience of services the least favourably. The most recent survey data shows that only 48% of Community Mental Health Survey respondents rated their overall experience as 8, 9 or 10, compared with 55% of Urgent and Emergency Care Survey respondents, 70% of Adult Inpatient Survey respondents, 85% of Children and Young People’s Survey respondents (parents/guardians rating their child’s experience) and 89% of Cancer Patient Experience Survey respondents.
Service users are asked whether, in the last 12 months, NHS mental health services have given them any help or advice with finding support for different aspects of their lives. Those who said that they already had support or did not need support have been excluded. As of 2024, physical health needs are the best supported, with the highest proportion of service users (29%) reporting that they had definitely been given help or advice. Help with finding or keeping work and financial advice or benefits are less well supported. In 2024, only 14% of respondents said that they had definitely been given help or advice with finding or keeping work and 17% of respondents said that they had definitely been given financial advice or benefits. Data from 2023 and 2024 are not comparable with previous years’ data, see more in the ‘About this data’ section.
Between 2020 and 2022, support across all categories declined. The proportion of service users who reported that they definitely received help or advice with support for finding or keeping work decreased slightly from 27% in 2020 to 26% in 2022. Those that definitely received help with finding support for financial advice or benefits decreased more significantly, from 30% to 25%. Support for physical health needs also worsened, with 34% of respondents saying that they definitely received help or advice in 2020 compared with 31% in 2022.
Although the employment gap between those with and without mental health problems has been improving over the last 10 years, estimates from 2022 reveal that a sizeable gap of 23-42% across the UK still remains. Additionally, the financial pressure imposed by the cost of living crisis is worse for those with mental health problems than those without. In this economic climate, the need for employment and financial support is especially imperative.
The proportion of Community Mental Health Survey respondents who felt they were given enough time to discuss their needs and treatment decreased from 90% in 2014 to 84% in 2022. Between 2014 and 2022, the proportion of people who felt they were not given enough time increased from 10% to 16%.
In 2023, the methodology, sampling months and questionnaire content changed, rendering the data not comparable with previous years (see ‘About this data’ below). In 2024, 84% of respondents felt they were given enough time to discuss their needs and treatment.
Once a mental health care plan has been agreed, it is important for service users to have regular review meetings with their care coordinator to ensure that support continues to meet their needs. Between 2014 and 2019, service users were asked, ‘In the last 12 months, have you had a formal meeting with someone from NHS mental health services to discuss how your care is working?’ The percentage of respondents who said that they had a formal meeting with someone from NHS mental health services to discuss their care decreased from 74% in 2014 to 71% in 2019.
In 2020, the question was amended slightly to ‘In the last 12 months, have you had a specific meeting with someone from NHS mental health services to discuss how your care is working?’ The results are not comparable with previous years for this reason (see ‘About this data’ below). In 2022, 61% of respondents said that they had a meeting to discuss their care in the last 12 months; this figure had fallen by 14 percentage points over the previous two years.
In 2023, the methodology, sampling months and questionnaire content changed rendering the data not comparable with previous years (see ‘About this data’ below). In 2024, 57% of respondents said that they had a meeting to discuss their care in the last 12 months.
Respondents who knew who to contact out of hours in a crisis, and had tried in the previous 12 months to make contact, were asked if they got the help they needed. In 2024, 40% of respondents said they ‘definitely’ got the help they needed when they tried to make contact. However, 27% of respondents did not get the help they needed.
About this data
The Community Mental Health Survey is sent to a random sample of service users from each trust, aged 18 and over, who received specialist care or treatment for a mental health condition within a specified period. The survey asks people about their overall care, crisis care, access and coordination of care, medicines, and additional support.
Respondents who stated that they did not know or could not remember are excluded from the survey results. To enable national comparison between years, data is weighted to account for differences in response rates between trusts. Further weighting accounts for differences in response rates at a given trust each year, across age groups or genders.
The Community Mental Health Survey underwent two major redevelopments in 2010 and 2014 to revise its methodology and questionnaire content to reflect changes in policy and best practice. The results for most questions from the 2019 survey are comparable with the 2014 to 2018 surveys. Question 16, which asks, ‘Do you know who to contact out of office hours within the NHS if you have a crisis?’ was amended in 2019 by adding the text ‘within the NHS’ to ensure respondents think about NHS services only. Therefore, this question is not comparable with any previous years.
In 2020, fieldwork for the Community Mental Health Survey was carried out between February and June 2020. Survey responses were received both before and after lockdown measures were implemented in response to the Covid-19 pandemic. The scale of changes made by services due to the pandemic was found to vary between trusts. Some trusts received most of their responses before the lockdown, while others received all responses during the lockdown. In general, results were found to be more positive than in recent years. However, analysis carried out as part of the survey found that it cannot be ruled out that this resulted from changes in service delivery or public attitudes towards the NHS during the pandemic. Therefore, caution should be taken when comparing the 2020 survey results with previous years.
For the 2022 Community Mental Health Survey, people were eligible if they received treatment for a mental health condition between September 2021 and November 2021. Fieldwork took place between February and June 2022. There are some questions in the survey where the results are only comparable with 2020 results, and not previous years. To reflect this, some charts only have a time series that dates to 2020.
The 2023 Community Mental Health Survey data differs significantly from previous years due to major changes in methodology, sampling period, and questionnaire content, rendering the 2023 results not comparable with prior years. Key updates included a shift from a paper-only questionnaire to a mixed mode allowing online responses, a shortened sampling period from September-November to April-May, and revised eligibility criteria to include 16- and 17-year-olds while excluding individuals using memory clinics. These adjustments led to a complete redevelopment of the questionnaire, breaking the trend data and shortening fieldwork from 18 weeks to 13 weeks.