A new report from the joint review of adult community mental health services conducted by the Healthcare Commission and the Commission for Social Care Inspection (CSCI) No voice, no choice: A joint review of adult community mental health services in England (pdf 745kb) presents a patchy picture of service development. Based on fieldwork in 2005/6 the review found that despite social attitudes becoming more inclusive, people with mental health problems continue to face exclusion from areas of life that many of us take for granted: jobs; family support; community involvement and choice about their care and treatment.
One in six people suffers from mental health problems, such as depression and schizophrenia, at some stage of their life. The majority of people who suffer from mental illness receive their treatment and care in their own community, not in hospital. Community mental health services should therefore offer people flexible services which meet their needs without disrupting their homelife.
Nearly half the LITS (Local Implementation teams) were rated fair or weak. The worst areas were London and the South East. The best were the South West and North East.
Half the service users interviewed did not have an emergency telephone number at a time of crisis; 59% of LITs had no 24 hour crisis accommodation and there was a shortage of talking therapies for those with schizophrenia.
The review calls for more attention to be paid to physical health which were not well recorded at local level. It was concerned too at the limited take up of direct payments.
Only 21% of mental health service users were in paid employment compared with 755 of the general population- a figure described by the review as ‘exceptionally low’. The position on Community Development workers is also disappointing with 66% of LITs having less than half the planned number of workers in place. This poor progress is compounded by a survey of staff in mental health trusts showing that less than a third had received any diversity training.
The review was carried out in 2006 and services will have been working to improve their performance. The forthcoming Mental Health Patient Survey 2007 should identify the level of improvement.
Terry Bamford
August 2nd 2007
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