What did people tell us about adult mental health services during the pandemic?

In 2019, NHS England published the Long Term Plan, which laid out the ambitions for health and care for the following 10 years. Mental health was a major focus of the Long Term Plan, with pledges to put greater focus on it, and give it an increasing proportion of the NHS budget. The need for this is clear: the NHS reported that at the end of February, 1.5 million people were in contact with NHS mental health services.

During the development of the Long Term Plan in 2019, Healthwatch England engaged over 40,000 people across England to find out what people wanted from the next ten years of the NHS. Mental health was one of the principal topics people told us about, with experiences being largely negative.

In a survey of over 5,000 people with certain long term conditions, 52% of those who had experience of NHS mental services described the experience as negative, with only 23% positive. That negative figure is higher than other services: with only people with autism had more negative experiences of the NHS. Reasons for this include long waiting times for diagnosis, assessments, referrals and treatment, and a lack of available support in the meantime. People also felt GPs were ill-equipped to provide mental health support, and people felt they could not access the right treatment or could not do so for as long as they wanted.

With the Long Term Plan due to be updated following the Covid-19 pandemic, we have taken a look again at what our data now tells us about mental health. This report focusses on adult mental health, with a separate one focusing on children and young people’s mental health.

Before the pandemic, most of the feedback we received on mental health was negative. This continues to be the case in 2021/22. In 2019/20, we heard from 759 people about their experiences of mental health services. 65% of these experiences were negative, whilst only 11% were positive. This was much more negative than our overall data for all services.

In 2021/22, we heard from far more people about their experiences of mental health services, with 1,451 people telling us about their experiences. 58% of people told us their experiences was negative, compared to 14% positive. Whilst the negative figure has come down, it is still higher than for all services. Additionally, for all services the positive figure has increased a large amount, whilst for mental health the increase in positive experiences lags far behind, only increasing by 3% compared to 15% for all services.

Key findings from this research

• GPs vary in how well-equipped to deal with mental health issues they are, and people can struggle to get their GP to refer them for specialist mental health support.
• Waiting times are long at all stages of the mental health system.
• Crisis services are over-subscribed and therefore often inaccessible.
• Assessments can feel perfunctory and often do not lead to the outcome people want.
• Inpatient treatment is an unpleasant experience, whilst community treatment is patchy and at times unhelpful.
• Services communicate poorly both with patients and with other services.
• Treatment often ends too early, before people feel they are ready, and without adequate follow-up support.