An alternative guide to mental health care in England

Comments: 23

Every year, one in four of us will experience a mental health problem. The experience will be different for each of us, as will the type of support we need.

But what mental health services are there? And how do they fit in with other health and public services? Watch our animation to find out more.

Closed captions for this animation are available on our YouTube channel. You can also read the transcript below.

We recommend watching the animation in full screen.

About this animation

Released to coincide with World Mental Health Day on Saturday 10 October 2015, the animation was produced with input from three experts by experience and advice from a mental health nurse and a senior colleague from a mental health charity.

We recognise that the experiences of the three characters in the film will not reflect those of all mental health service users. Everyone’s needs and experiences of mental health care are different, and the availability and quality of services varies across the country. Our aim was to create something that would demonstrate the range of services available but also highlight some of the issues that need to be addressed.

More on mental health

Blogs, publications, projects, events and more are all available from our mental health topic page.

Find out more about our upcoming learning network on integrating physical and mental health care.


Good mental health isn’t just the absence of mental illness – it’s how we cope with our lives, how we handle situations, relate to others and make choices. It’s about how we think, act and feel.

Every year, one in four of us will experience a mental health problem. The experience will be different for each of us, as will the type of support we need.

But what mental health services are there? And how do they fit in with other health and public services? We’re going to follow three people to find out more.


Asif has diabetes. He manages it with support from the diabetic nurse at his GP surgery – although he doesn’t always find this easy.

His health deteriorates which affects his work and family life. He feels low all the time, and finds it hard to concentrate.

Even though depression is common among people with diabetes, his nurse has little mental health training and doesn’t ask the right questions to spot it. Eventually though, his GP does, and they talk through his choices.

His GP refers him for talking therapy. She also gives him some leaflets and details for a patient group.

The group and the self-help guides help at first, but there’s a waiting list for therapy, and during this time his depression gets worse and he’s signed off work. He’s less motivated to manage his diabetes so his physical health declines.

His GP decides he needs more support and refers him to a specialist diabetes clinic. Ideally, the team there would include mental health professionals and they would draw up a care plan together, but integrated services like this are quite rare. Without this, Asif’s mental health will continue to be treated separately to his physical health even though the two are related.


Alicia has started hearing voices. She moved back home after graduating and is feeling overwhelmed by her future. She thinks the TV and radio are talking to her which she finds very distressing.

Her parents do their best to support her but one evening she locks her bedroom door and threatens to harm herself. Her parents don’t know what to do so they take her to A&E.

A psychiatrist decides that she needs to be admitted to a psychiatric hospital. The team there draw up a care plan, including anti-psychotic medication to help with the voices.

When she’s well enough to be discharged an early intervention team takes over. These teams help young people experiencing their first psychotic episode. They work with Alicia, providing psychological therapy and support to her and her family.

Everything goes well at first. Alicia feels much better. She stops taking the medication because it makes her feel drowsy and she stops attending appointments with the team.

Her mental health deteriorates again. She’s picked up by the police while wandering the streets in a distressed state. They take her to a dedicated place of safety and call for the crisis team. These teams provide intensive support, helping people stay at home rather than go into hospital. They assess Alicia’s needs and visit her at home for a few weeks while she recovers.

She joins a support group run by a local charity, which helps her regain her confidence. With ongoing support, Alicia learns to manage her condition and get on with her life.


Mary has dementia. Her memory is failing and she gets confused about where she is.

Her husband looks after her, with some help from social services and an older people’s mental health team. Because of this she’s been able to stay living at home.

One day though she has a fall and has to go to A&E. She needs surgery so she’s admitted as an inpatient.

The hospital ward is busy and noisy - an upsetting environment for Mary. After a couple of days a liaison psychiatrist visits her on the ward. She helps staff understand Mary’s condition and what they can do to make her feel comfortable, but it’s still a confusing and distressing place for her.

She returns home, but her husband’s health gets worse and, despite increased support from social services, he’s finding it hard to care for her. The local authority assesses her needs and, with Mary, her husband and family, agree that she should move into a care home.

It’s difficult finding a place in a local care home where the staff are trained to care for people with dementia, but eventually, one becomes available. Mary isn’t better, but she has the care she needs.


As we’ve seen, mental health covers a range of different conditions and experiences.

People’s needs vary considerably and the services that are meant to support them don’t always work as well as they should. Asif’s depression could easily have gone unnoticed, Alicia could have been caught in a cycle of repeated crises, unsupported by community services, and Mary’s family might never have found a care home able to provide the specialist dementia care she needs.

Just as mental health is part of our overall health, mental health care is an issue for the entire health and social care system – from GPs to hospitals, community services to care homes.

All health and care services need to be designed with mental health in mind, and all health professionals have a part to play helping people get the right support at the right time.


#544958 Martin Creswell
Associate Director - Communications
North Essex Partnership Universityt NHS FT

This is great, will feature on our web site with link through to animation. Would also like to use in other promotional work. Will give Kings Fund full credit each time. Is that OK?



#544959 awaters
Digital Communications Assistant
The King's Fund

Hi Martin, 

Thanks for your comment and glad that you like the animation. Yes, that's fine to use it. 

#544961 Clare Lyons-Collins
Subject Expert Lead, Mental Health

Just love this, thank you.
Can we also post this internally at Monitor? We could also tweet tomorrow.

#544962 George Coxon
Various - care home owner, MHN, commissioning advisor

Really liked the storyboard and true to life stories and pleased Mary almost received timely care! - pity she needed to have a life changing fall before it was provided. Timliness of the right care and support is one of the biggest challenges to a struggling H&SC system. Preserving choice and ensuring good proactive care of the most vulnerable people in our communities is crucial. Prevention of avoidable hospital admissions should see greater connectivity with care homes that are both more conducive to safe and happy living as well as more cost effective too. I will use this animation too with our care home staff and kitemark home members. Brilliant supplement as we approach world mental health day. Great work.

#544963 Dawn Hyde
Mom / Carer & Mental Health volunteer

I'm a MOM , but I'm also called a Carer.
..My daughter has Schizophrenia, she was 18 when she 1st became Mentally Unwell.
She is now 27yrs old.......9yrs so far.....we've done.
I've seen some excellent care in some parts of the Mental Health Service , & in others the need for change & improvement & a different approach.
I started talking to my daughters Mental Health service...having an Honest Conversation, what works & what doesn't ,what needs to change & why.....The Mental Health service in my area has improved - why ...because it started listening to people & included service users & Carer's more in developing Policies Training ,Interviews etc it does feel more like OUR MENTAL HEALTH SERVICE.
Yes its a difficult time in all of the NHS....yes Mental Health needs more money & the NHS as a whole should be more Mental Health aware across all services...let's face it is 2015.
Xx Dawn

#544965 James Higgott
Digital Communications Manager
The King's Fund

Clare - Please feel free to use the video at Monitor. It is freely available for all to use on this website, Vimeo, YouTube and Facebook.

#544966 Norma Roberts

I've tried antidepressants, (many different ones),CBT, counseling, even ECT, and nothing really helped with the OCD. The only times it has been subdued, somewhat, is when I had severe agoraphobia, following a very violent relationship, and since I have got older, as I just can't do 4 hour baths anymore!

Most of my life was ruled by this condition, we need cures. Much more research is needed;tablets and "talking about it" just don't hack it for a lot of us!

#544967 Moira McLoughlin
Senior lecturer University in nursing education
University of Salford

This is a great resource for teaching thank you - I have tweeted the link to colleagues and students via our school account and also by using a hashtag it will also embed in a safeguarding module I lead. I hope that's okay?

#544968 Chris Herbert M...
Development Director
Brighter Futures

This is good; really good, and I appreciate that within a short timeframe its not possible to include everything. However it misses the vast and incredible range of services provided by the Voluntary and Community Sector. Imagine the three examples also being in contact, where needed, by housing support, innovative day services like Clubhouse, out of hours telephone helpline, safe spaces (crisis) when other MH provision is closed, arts and music, horticulture and 'men in sheds', gender specific and safe day opportunities, well-being and life skills, volunteering, peer support, work placements.
Actually I could go on but I'm sure you get my drift. Anyway ... come to North Staffs and you can have all those things. Integrated, seamless, community based, recovery focused support for people whose lives are affected by mental ill health.
Any one of our customers can have some, or all of those services. It costs somewhere in the region of £750 - per person, per year.

#544969 awaters
Digital Communications Assistant
The King's Fund

Moira - Yes, please feel free to use the video. Thanks very much for sharing it. 

#544970 paul mcdonald
senior lecturer
Newman University Birmingham

This is a fabulous animation. We will show it to our first year students studying for a degree in Health & Social Care.

Another great resource from Kings - thank you!!


#544974 Rani Prasad
Consultant Clinical Psychologist
5 Boroughs Partnership NHS Foundation Trust

Think this video is good and raises the issue that mental and physical health services need to work together for the overall health of patients.

#544976 Glenor Roberts
Parent Family Coach

What an excellent way of giving the information. I felt that all my learning senses were being engaged. I could talk about Asif, Alicia and Mary afterwards, in some detail so I know that I have been helped to learn while listening and watching.

I appreciated the use of movement to change the landscape as the information was being presented. That helped me to understand the interconnectedness of e.g. people, place and services. I understand that was one of your main purposes and it worked. The approach also demonstrated very well, the reality of each person's situation and needs being different as well as changing.

I would like to be able to show this on my website too, when I've finished re-building it - perhaps end of November. Parents and parenting practitioners visiting the site could then view the information as it might be immediately relevant to them.

Well done to Kings Fund and your talented Creative Connection people.

#544987 Amanda Price
Associate Director Education
Guys and St Thomas' NHS Foundation Trust

Thank you this is useful for our staff students and trainees, as well as my friends and family.

#544989 Cheryl Parlour
Occupational Health & Wellbeing Administrator
University of Essex

This is a very interesting video. Would there be any way of downloading this for us to use in Mental Health presentations for education purposes?

#544990 Durgadas Menon
Communications Consultant

This is an excellent way of presenting complex problems arising in mental health care and support network. I think a series of animations from different countries and settings will make it a compelling case for international health policy experts to pay heed to include mental health in the larger public health debates.

#544991 awaters
Digital Communications Assistant
The King's Fund

Cheryl - Glad you enjoyed it. You can download it here, via our Vimeo page (click on 'Download' below the video). 

#544992 Mark Rickenbach
GP and Professor of Healthcare and Education Quality
Winchester University

Care works well when those involved in healthcare work proactively and invest time to co-ordinate care and predict problems. The question is how we make this more seamless and linked in an integrated way. It needs co-ordinated records, clear information on access to help, and clear named leads to provide continuity. Thankyou to all those who provide care including family and friends

#544994 Haroula Stathopoulou
University Lecturer
University of Bedfordshire

excellent resource for teaching

#545017 Cheryl
Occupational Health
University of Essex

Thank you for the link!!

#545093 John Kapp

Well done. Mindfulness Based Cognitive Therapy (MBCT) 8 week courses could help Asif, Alicia and even Mary, because they teach how to look after yourself better, and develop self regulation of your amygdala (smoke detector of the brain), which tends to shout 'fire' inappropriately. Health and Wellbeing Boiards and Clinical Commissioning Groups have the power and the money (Better Care Fund of £3.8 bnpa this year, of which the average CCG gets £20 mpa for Asif, Alicia and Mary. Although this money is 'in the bank', the procurement procedures for tendering outcome based contracts for Community Care Centres near every GP surgery is not. I have devised such a system, see papers on section 9 of I can be contacted at, and 01273 417997.

#545218 Sue

Reading Mary's story makes it sound as though being in the system will look after you Not so for my daughter who had access to all the services they just didn't care as much as your example Don't fool people into thinking every regional service is as caring and dedicated as the one Mary was under .

#548380 kara

well im only 12 and going through a lot on some sheets ive been given, I was told to go on this website.... I found it useful at first and then got a bit confused. I found that the video that I watch with all the people in it made me realise im not alone, as I always feel loney . I guess, a lot of people are going through what we are going through and i'm happy that im not alone and will probable visit this website again when I am down again. Thank YOU!!

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