Dissatisfaction Within NHS Mental Health Services

The 2024 Community Mental Health Survey paints a stark picture of persistent dissatisfaction within NHS mental health services in England.

A central concern highlighted in the report is the prolonged waiting time for initial treatment and the lack of interim support while waiting. Over 33% of service users waited more than three months for their first treatment appointment, with 40% receiving no interim support, despite clear evidence that delays exacerbate mental health deterioration. Among those who waited over six months, 71% reported a deterioration in their mental health. The situation is even more critical for children and adolescents: 45% of CAMHS (Child and Adolescent Mental Health Services) users waited more than three months, and 53% had no support while waiting. These figures not only illustrate the extent of service strain but also point to a breach in the NHS’s responsibility to provide timely and preventative care. For many, these delays are not just inconvenient—they are harmful, leading to avoidable escalation of mental distress and worsening outcomes.

In addition to issues of access, many service users reported feeling excluded from decisions about their care. A further 38% of respondents lacked a care plan, and nearly half had no review meeting, leaving many without coordinated, consistent guidance. In crisis situations, over 27% did not get the help they needed, and 47% of carers received no support—a stark indication of a system struggling to deliver on its commitments to person- and family-centred care. Such figures reveal a worrying lack of shared decision-making and care coordination.

Medication management and communication also emerged as sources of concern. Nearly one-third of respondents reported that the side effects of medication were never explained to them, and 35% had not been told what would happen if they stopped taking their medication. These omissions can lead to poor adherence, increased risk of relapse, and loss of trust in the therapeutic relationship. While many respondents had been asked how they were coping with medication, a significant minority had not—suggesting inconsistency in clinical practice and patient engagement.

(Source: https://doi.org/10.12688/wellcomeopenres.17973.1)

The root causes of these issues are structural. The NHS has seen a 45% rise in demand for secondary mental health care over five years—far outpacing resource and workforce growth. As of 2024, the system faced over 109,000 children and young people waiting more than a year for treatment. Staffing remains chronically inadequate, with only 268 of 1,040 planned psychiatrists and 6,988 of 12,320 nurses recruited under key policy targets. The sector's 14.8% nursing vacancy rate reflects widespread burnout and retention challenges.

The Health Foundation's 2023 report "Health in 2040: Projected Patterns of Illness in England", includes anxiety and depression among the 20 major health conditions analysed and projects a 16% increase in the number of diagnosed cases by 2040. This is one of the more modest increases among high-impact conditions but still reflects a growing mental health burden. The rise is partly due to factors such as population ageing, economic stressors, and increasing multimorbidity. Mental health issues like anxiety and depression are especially prevalent among working-age adults and are strongly associated with reduced productivity, long-term sickness absence, and increased use of both primary and community-based care. Notably, the report identifies these conditions as being primarily managed in primary care, reinforcing the need to invest in GP services and community mental health support to handle increasing demand. The complexity of managing mental health alongside other long-term conditions is also expected to increase.

From the user perspective, delays and fragmentation in mental health care lead to worsening symptoms, disempowerment, and distrust. The absence of personalised, proactive, and accessible support systems disproportionately harms vulnerable groups—such as youth and minority populations. This growing unmet need signals a strong demand for intelligent digital tools that can assess, stratify, and support patients dynamically—long before they reach crisis point.