Mental health services in Brighton and Hove - experiences of service users and professionals

Healthwatch Brighton & Hove undertook research into people’s experiences of mental health care.  They spoke to 274 people, both service users and professionals.

Both service users and professionals were generally complementary about mental health providers, mentioning organisations and individuals who had provided high quality of care. Service users spoke positively about being “listened to and treated with concern”, but less positively about providers “addressing [their] needs or making plans to do so”, perhaps reflecting the short-term nature of some support.

Both service users and professionals were also acutely aware of the stretched, under-resourced nature of the mental health and housing service in Brighton and Hove.

Nearly two thirds of service users had approached their GP for help in accessing mental health services. However, comments from some showed that their GP did not understand their emotional needs, sometimes misdiagnosing their condition, treating the physical need rather than seeing it as a mental health symptom, and there was a tendency to rely on medication rather than therapy.

Some service users reported they did not know where to go for mental health support. Comments from both professionals and service users indicate that there was not enough public awareness about these services and how to access them.

When service users were referred, many comments told of long waiting lists, or being offered services that had been tried and test before without success. There was also a lack of out of hours support offered. The majority of professionals (92%) knew where to go for crisis support, but only 16% were confident that their clients would be able to get the help they required. Leading comments from professionals indicated that thresholds were too high and waiting times were too long and this was often linked to the knowledge that services were generally under pressure, under resourced both in funding and personnel.

These issues were compounded by a lack of joined up services. Both professionals and service users commented on the need for better communication within the NHS and between NHS mental health services and third sector organisations. This was exemplified by the sometimes poor transition from children and young people’s services to adult services.

Where service users were offered support, the timescale for this was felt to be too short and sometimes lacked consistency i.e. not having access to the same practitioner. In addition, service users spoke about the lack of follow-up care, which was particularly disappointing if progress had been made, often resulting in a return to the system, further waiting and another round of similar short-term support

Both service users and professionals commented on the lack of tailored support to meet user needs. These included people who had identified as LGBTQ+, people whose first language was not English, people from the travelling community, ethnic minority groups, people diagnosed with neuro-diverse conditions, patients dealing with alcohol and substance addictions and those in temporary support or homeless. Service users also spoke about the importance of offering therapies that specifically dealt with bereavement, trauma, domestic abuse, and post-natal depression.

Seven in ten professionals said their clients were not able to access accommodation suitable for their mental health needs. Some providers mentioned accommodation options having negatively impacted on their client’s mental health due to poor living conditions, the behaviour of other residents and being moved outside of the locality. Between 20% and 30% of service users 55 said they would like further support from therapy, the Brighton and Hove Wellbeing service, counselling, psychologists, or a GP.

In conclusion, mental health services and accommodation services in Brighton and Hove require further financial investment as well as redesign to make the most effective use of existing resources to ensure the service offered meets the required need. Comments from service users and professionals demonstrate that support for mental health conditions needs to be long-term, consistent, robust, and tailored to allow for a range of additional needs and circumstances. This is even more important when we consider the context of the COVID pandemic, in which the health and social care system has seen a significant increase in the demand for mental health support.