Patients face two-year wait for community mental health services

In some parts of the country, children have to wait 694 days for first contact with community mental health services, a data analysis has found

21st November 2023 about a 3 minute read
“We need access and waiting times standards for all mental health services, to help us improve national data and to direct and allocate resources effectively.” Sean Duggan, chief executive of the mental health network, NHS Confederation
“The urgency for improved access to mental health care services and products is greater now than ever before. Demand is growing at an unprecedented pace while solutions are complex to adopt within a fragmented system. At FCC, we are looking beyond what is currently in place and so heavily relied upon to find new and innovative ways to support people, both short and long term, and that aren’t so reliant on traditional means of treatment. For example, FCC has produced a digital mental health tools guide to show what is easily accessible to all as a potential short-term, interim solution.” Lauren Evans, director of research and innovation, Future Care Capital

More than 24,000 children and young people with mental health problems are waiting nearly two years to be seen by community mental health services, an analysis of data by the publication HSJ has found.

The data also showed that more 19,000 adults with a serious mental illness are waiting for longer than 18 months for a second contact with community mental health services. (HSJ says that waiting time for second contact is a more meaningful metric for adults than first contact.)

The median waiting time for children and young people from referral to first contact was 178 days, while the median wait time for adults from referral to “second contact” was 120 days.

The waiting list is divided into percentiles. Children in the 90th percentile were waiting an average of 694 days for first contact (just under two years), while the longest waits for adults averaged 583 days.

The three integrated care systems (ICSs) with the longest median and 90th percentile waits for children and young people were Coventry and Warwickshire, Northamptonshire and Cornwall and the Isles of Scilly. For adults, the equivalent three were Bristol, North Somerset and South Gloucestershire, Cheshire and Merseyside and North Central London.

Cambridgeshire and Peterborough ICS reported the shortest typical wait for children and young people at 53 days, while adults in Lincolnshire had the shortest wait at 60 days.

Rise in autism referrals

A Cornwall Integrated Care Board spokesperson told HSJ: “Like many areas across the country, we are seeing a significant rise in autism and ADHD referrals. This means demand is currently well in excess of commissioned activity. A new model and pathway of care has recently been agreed, which aims to improve access and reduce waiting times in this area.”

The NHS long-term plan proposes a standard four-week waiting time for children and adults to access community mental health services. Although this approach has been piloted, it is yet to be implemented.

Sean Duggan, chief executive of the mental health network at the NHS Confederation, said leaders would be concerned that patients were waiting so long for community services. He added: “We need access and waiting times standards for all mental health services, to help us improve national data and to direct and allocate resources effectively.”

Time and investment needed to boost capacity

Andy Bell, chief executive of the Centre for Mental Health, said the data was a “vital starting point for the transparency and accountability” needed to bring down waits. He told HSJ: “It will take time and continued investment to expand capacity, boost early intervention, and improve quality and equity of provision.”

Many of the integrated care systems with the longest waits said they were unable to validate NHS England’s’s data. Some told HSJ there were issues with data reporting and quality which could paint a worse picture than reality. Some, however, described the significant pressure community services have been under since the pandemic following a steep growth in referrals.

An NHS England spokeswoman said: “The most recent figures show that the NHS is now treating more young people than ever before, and the NHS is expanding services as quickly as possible within the current five-year funding arrangements to meet demand.”

FCC Insight

The surge in demand for community mental health services since the pandemic is clearly putting a lot of pressure on those services. The analysis by HSJ showing that some children and young people desperately in need of mental health support now have to wait up to two years means that many are effectively struggling alone and unsupported. There is a real concern that, in these cases, the mental health problems might reach crisis point, further adding to the misery of those children as well as adding to the pressure on services. There is a strong case now both for investing more in community mental health services and finding alternative ways to support young people experiencing mental distress.