Community mental health standards: what will it mean for people who use services?

When a person comes out of hospital after they are treated for a mental health condition, the right care plan is a crucial part of their recovery. Dr Sarah Markham, patient representative for PRSB, speaks about her experiences and why she wants care plans to be standardised and made available to the people involved in a person’s care.

Please can you tell us a bit about you and your experiences using mental health services?

I have been a mental health patient in a range of inpatient and community settings following a serious suicide attempt which left me with multiple injuries in 2007. I had suffered from anxiety and depression since my late teens, but found it hard to access treatment and felt as though I was discounted by GPs and other health care professionals as I was articulate and academic. I experienced intense and chronic feelings of suicide over a period of 18 months, but it was not until the suicide attempt that I ended up as an inpatient in hospital. My experience of mental health services has been mixed. I, along with many of my peers, don’t always feel listened to by my mental health professionals, who don’t always understand the value of self-reporting. This has been reflected in a national survey conducted by the Department of Health and Social Care as part of the Independent Review of the Mental Health Act (MHA), which I supported in 2018. It’s very common for people to feel like support or treatment is something that is being done to them rather than with them.

What were the biggest challenges for you in terms of joined up services and information sharing?

Information that should be shared between different care teams and services is not always used and sometimes can’t be found. For instance, I have a relapse prevention care plan which I constructed two years ago with support from a psychologist. But my community mental health care team don’t adhere to the care plan.

When anyone is discharged from an inpatient setting, they can experience multiple anxieties. During an inpatient stay, people may be treated as though they are incapable of assuming adult responsibilities, only to be discharged right back into taking responsibility for their own well-being. An appropriate transition period is crucial to help them to rebuild their self-confidence and re-accustom themselves to the outside world, which is why a shared care plan is crucial.

What inspired you to support the community mental health project as a patient leader?

I got involved as patient leader on this project because I believe there is a real need within mental health services to respect the contribution patients can make to their own care planning and management. This also needs to be incorporated into care records in a way that means it can be used and shared within and between services.

If implemented, how do you feel a standardised community mental health care plan could support and benefit people with existing mental health problems?

It could encourage and support mental health professionals and services to respect and value patient self-knowledge and reporting, then record this appropriately in the records in a way which makes it accessible and usable by other care partners. Hence the value of having and promoting use of the ‘About Me’ section in the standardised community mental health care plan. If mental health staff and services were able to be more responsive to the preferences, needs and concerns expressed by patients themselves, this would improve accessibility, confidence in services and patient experience. Inevitably this will lead to better outcomes for patients and reduce hospital admissions.

How do you feel that services could be more personalised for individuals and how would this aid recovery?

The ‘About Me’ section, which records information that is meaningful and relevant to the individual, is ideal for this purpose. Patient access and transparency about what is recorded is essential, and will help people to build effective and therapeutic relationships with professionals. It is the perfect place for a person’s views, preferences and wishes concerning which types of care and treatment and mental health settings work best for them, including types of medication and psychological therapy. It might also be a place for people’s concerns about their treatment to be recorded and tracked, so they don’t get lost in the system.

For more information on the community mental health project please contact info@theprsb.org