Demand and activity
The latest Mental Health Service Dataset (MHSDS) monthly performance data for September 2024, published in November, highlights the continuous growth of demand for mental health and learning disability services. There were 1.98 million people in contact with mental health services in September, another record high. Contacts are up by 8.8% compared to a year ago and are 47.5% higher than pre-pandemic levels (September 2019). Despite this, the data also shows how trusts are increasing activity to keep up with demand and meet key national targets.
The significant spike in demand and the limited capacity across the sector has led to a rise in out of area placements. A new report published by the Health Services Safety Investigations Body (HSSIB) on 'inappropriate' out of area placements (OAPs) highlights the impact of patients being placed in a mental health inpatient facility that is far from their home. Prior to the Covid-19 pandemic, the UK government set a national ambition to eliminate inappropriate OAPs by the end of 2021. However, the latest data show that at the end of September 2024, there were 396 inappropriate OAPs in adult acute beds, an increase of 90 OAPs since the previous year (306 in September 2023) and up by 273 in April 2023.
The Mental Health Bill was recently introduced to parliament. The Bill aims to modernise current mental health legislation and will give patients greater choice, autonomy, enhanced rights and support, and ensure everyone is treated with dignity and respect throughout treatment. In September 2024, a total of 22,868 people were subject to the MH Act at the end of the reporting period, with 16,699 detained. This is up by 6.5% compared to the same time last year. The new Mental Health Bill proposes to end the inappropriate detention of autistic people and people with a learning disability. Latest data taken from the assuring transformation data collection shows that there were 2,050 learning disabilities and/or autism inpatients at the end of October 2024. This is an increase of 30 patients since the previous month.
Figure 8
Number of patients in contact with mental health or learning disabilities services
Community mental health
The number of children and young people (CYP) accessing mental health services, whether that be in the community, schools, digital services, or the voluntary sector, continues to rise. In the 12 months to September 2024, a total of 798,479 CYP were supported through NHS funded mental health with at least one contact. This is an increase of 8% compared to the same time a year ago and an additional 284,515 contacts since the full set of ambitions for CYP mental health services were set out in the NHS Long Term Plan. However, the latest data also shows that in the three months to September 2024, 352,682 children were still waiting for treatment, an increase of 5.9% compared to the last three month-rolling period which highlights the growing demand for mental health services among children and young people and the urgent need for increased capacity and resources.
As of September 2024, 119,469 adults and older adults with a serious mental illness received their second contract with community mental health services, an increase of 8.5% since the previous month, while 240,832 adults with serious mental illness were still waiting for treatment, an increase of 2.4% since last month. Median wait times for these individuals have fallen from 122 to 113 days since the previous month.
Intervention-specific performance and waiting times
Eating disorders
The children and young people eating disorder standard states that by March 2020/21, 95% of children and young people who are referred for assessment or treatment for an eating disorder receives treatment within one week for urgent cases, and four weeks for routine cases. Between July 2024 and September 2024, 75.7% of patients with eating disorders categorised as urgent cases started treatment within one week and 76.0% routine cases started treatment within four weeks, both missing the national target.
Figure 9
Percentage of urgent and routine cases seen within one and four weeks
Talking Therapies
Although targets are not being met in some mental health services, there has been notable success in others such as access to NHS talking therapies where key national targets continue to be met. In September 2024, 91.9% of referrals who finished a course of treatment in the month, accessed NHS Talking Therapies within six weeks, meeting the national waiting time standard of 75%. This is the same figure as the previous month.
Figure 10
Percentage of referrals accessing NHS talking therapies within six weeks
Urgent and emergency liaison mental health services
Urgent and emergency liaison mental health services play a crucial role in ensuring timely care for individuals experiencing a mental health crisis. NHS England have recently began publishing data on demand and call handling related to accessing crisis care via the NHS 111 'select MH option'. This data intends to support operational decision making and strategic planning across the crisis care system. The data shows that in September 2024, 144,230 calls to access crisis care through NHS 111 were received, equating to 4,973 calls received per day in September. This is a slight decrease of 0.6% since the previous month. Of the calls received, 101,238 were answered (70% of calls received).
The evidence-based treatment pathway (EBTP) standard for urgent and emergency liaison mental health services states that any person experiencing a mental health crisis should receive a response within one hour. The latest data shows that in September 2024, there were 23,768 new referrals to liaison psychiatry teams from A&E with first face to face contact. Of these, 65% (15,507) first received first face to face contact within one hour. This is a same proportion to the previous month.