Transforming Mental Health

Healthwatch Richmond organised a public engagement event on behalf of Richmond Clinical Commissioning Group to discuss plans for transforming local mental health services. The event attracted 109 attendees, including people with lived experience of mental health services, carers, members of the public, NHS staff, social care professionals and voluntary sector representatives. A total of 140 comments and submissions were collected through discussions, feedback forms, question-and-answer sessions and an ideas board. 

A major theme was the need to improve crisis care. Attendees reported mixed experiences of crisis lines, A&E departments and emergency mental health support, with some feeling services were difficult to access or unhelpful during periods of acute distress. Participants called for a more responsive crisis system, improved support after discharge from services and greater availability of local crisis alternatives such as crisis cafés. Concerns were also raised about gaps between inpatient services, home treatment teams and community mental health services.

Children and young people's mental health was another significant issue, despite the event focusing on adult services. Participants highlighted long waiting times for Child and Adolescent Mental Health Services (CAMHS), difficulties transitioning from children's to adult mental health services and the need for earlier intervention to prevent mental health problems worsening over time. Several attendees emphasised the importance of resilience-building, school-based mental health support and preventative approaches for young people. 

Access to services was a recurring concern. Participants emphasised the importance of locating services within easy reach of all parts of the borough and expressed anxiety about planned changes to facilities at Richmond Royal Hospital. People also reported difficulties understanding referral pathways, finding information about available support and accessing services when they needed them. Concerns were raised about long waiting times for community services, counselling and psychological therapies. 

Support for people with autism emerged as one of the strongest themes. Attendees felt that mental health services were often designed around neurotypical needs and did not adequately support people with autism or Asperger's syndrome. Concerns included a lack of autism-specific provision, poor understanding of autism within services, limited support during transitions from children's to adult services and insufficient signposting to appropriate local resources.

Participants also highlighted the impact of wider social factors on mental health, particularly housing shortages, welfare issues and benefit delays. Many argued that poor housing security and financial pressures were contributing directly to poor mental health and making recovery more difficult. The discussion reinforced the importance of integrating health services with housing, social care and community support. 

Healthwatch concluded that improvements were needed across crisis care, community mental health services, CAMHS, autism support, signposting, access to therapies and preventative services. Recommendations included developing more effective crisis support, improving transitions between services, strengthening support for people with autism, expanding therapies for older adults, improving access to information, considering the impact of housing and welfare issues, and ensuring service users remain central to service redesign and evaluation.