Understanding what community mental health care is like for service users provides key information about the quality of services across England. 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 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 over time. In 2021, 48% of service users rated their overall experience as 8, 9 or 10 and 10% rated their experience as 0, 1 or 2. People were eligible for the 2021 Community Mental Health Survey if they received treatment for a mental health condition between September and November 2020. Fieldwork (the time when questionnaires are sent out and returned) took place between February and June 2021.
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 show that only 48% of Community Mental Health Survey respondents rated their overall experience as 8, 9 or 10, compared with 72% of Urgent and Emergency Care Survey respondents, 75% of Adult Inpatient Survey respondents, 80% of Children and Young People’s Survey respondents (parents/guardians rating their child’s experience) and 88% 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 various aspects of their lives. Those who said that they already had support or did not need support have been excluded. Physical health needs are the best supported, with the lowest proportion of service users reporting that they had not been given any help or advice. Help with finding or keeping work and financial advice or benefits are less well supported.
In 2021, 47% of respondents said that they had received no help, but would have liked it, with support for finding or keeping work. 48% said they had received no help with finding support for financial advice or benefits. 39% received no help with support for physical health needs, but would have liked it. Data from the 2020 Community Mental Health Survey is not comparable with previous surveys (see ‘About this data’ below).
The proportion of service users who reported that they did not receive any help or advice with support for finding or keeping work increased from 43% in 2020 to 47% in 2021. Those that received no help with finding support for financial advice or benefits increased similarly from 43% to 48%. Support for physical health needs has also worsened, with 36% of respondents saying that they received no help or advice in 2020 compared with 39% in 2021.
The proportion of Community Mental Health Survey respondents who felt they were given enough time to discuss their needs and treatment has decreased over time, falling from 90% in 2014 to 85% in 2021. Between 2014 and 2021, the proportion of people who felt they were not given enough time increased from 10% to 15%.
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 2021, 66% of respondents said that they had a meeting to discuss their care in the last 12 months; this is a statistically significant decrease from 2020, when 75% of respondents said they had had a meeting.
Community Mental Health Survey respondents are asked if they know who to contact out of office hours if they have a crisis. Between 2014 and 2018, the proportion of respondents who knew who to contact if they had a crisis increased from 68% to 71%. The question was amended in 2019 to specifically ask if service users know who to contact within in the NHS. In 2019, 69% of respondents said they knew who to contact out of office hours within the NHS if they had a crisis.
In 2020, the question was amended slightly from “Do you know who to contact out of office hours within the NHS if you had a crisis?” to “Would you know who to contact out of office hours within the NHS if you had a crisis?”. This change was made to clarify that the question was asking whether respondents had been provided with information which they could easily access about who to contact, rather than asking whether they knew the specific details of who to contact. 74% of respondents said that they would know who to contact in 2021, which is a statistically significant increase from 72% in 2020.
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 2021, just under half (49%) of respondents said they ‘definitely’ got the help they needed when they tried to make contact. However, 20% of respondents did not get the help they needed and 3% of respondents were not able to make contact.
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 time period.
The survey asks people about their overall care, crisis care, access and coordination of care, patient involvement, 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. A further weighting accounts for differences in response rates at a given trust in a given 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 the majority 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 2021 Community Mental Health Survey, people were eligible if they received treatment for a mental health condition between September 2020 and November 2020. Fieldwork took place between February 2021 and June 2021. Some questions asked participants to reflect on their care over the last 12 months, thus reflecting experiences of care throughout the pandemic. 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 back to 2020.