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Mental health under pressure


There can be little doubt that the mental health sector is under pressure, however understanding the nature of those pressures has been difficult.

The mental health sector comprises a number of inter-related services covering a range of different conditions which together create a system of care. This briefing paper aims to focus on mental health as a system of care, examining individual pressures within the wider context of provider and commissioner actions. Although services for children and adolescents, and older people are very much part of this system of care, this briefing paper focuses on services for adults between the ages of 16 and 65.

Our analysis is based on a review of the literature, national datasets, survey data and analyses from other bodies, and data collected as part of our quarterly monitoring report survey. In addition, we have conducted new analyses of NHS provider board papers, annual reports and strategic plans. It is well established that the availability of robust data and national information on mental health services is limited and this means that quality of services cannot be definitively assessed. We have drawn together information from a number of different sources each of which provides a particular insight into provision and quality in order to provide an overview of the state of mental health services and care in England.

In focusing on the pressures in mental health we have predominantly highlighted negative outcomes. This does not preclude that some pressures and actions have resulted in positive outcomes or that there are individual examples of good practice. Despite this there is little evidence that the pressures identified are only limited to specific areas of practice or individual providers, and many areas of pressure such as crisis care have been the subject of national focus and policy initiatives.