Many people with mental health needs are not getting the care they need, the Care Quality Commission (CQC) highlighted in a report published today, 13 March 2025.
As part of its monitoring activity in 2023/2024, CQC interviewed over 4,500 people who were detained under the Mental Health Act or ‘sectioned’, covering 870 wards, and speaking to relatives and people who were previously detained. This year’s Monitoring the Mental Health Act report once again raises that a lack of staff, beds, and training, are leading to harmful gaps in care and treatment.
With demand far outstripping capacity, there are not enough beds available, meaning people are placed far from home, their family, and their friends. One mother who was detained was placed 5 hours from home and because of this she didn’t receive any visitors during her time in hospital. Another woman had to wait hours in a police staff room, accompanied by two police officers, while a bed was sourced.
There are not enough staff to support all patients, which is affecting people’s access to care and leading to people being restricted from going outside as there is nobody to supervise them, or in the most extreme cases, people being inappropriately confined.
While many people describe healthcare workers as “caring” and “wonderful”, there are ongoing concerns with staff numbers and training. In particular, not all staff have undertaken the mandatory training to understand the needs of autistic people and people with a learning disability.
The combination of overwhelming demand and limited resources has led ward managers to feel pressure to discharge the “least unwell” patients. One woman reported being discharged before she was ready and without support to find her way home; she subsequently overdosed. Another person said, “I was only discharged because I was 18, not because I was better.”
Despite a legal entitlement to aftercare, overstretched general practice and community mental health services are not always able to provide a supportive transition back into the community, meaning people do not have the best chance at recovery. In nearly half of cases where a child or young person was detained, they had to be re-admitted within a year.
Young people, people from ethnic minority groups, and people from areas of deprivation face the biggest barriers to accessing care and are sectioned at higher rates than the general population. Black people in particular are detained at 3.5 times the rate of white people. Meanwhile people from the most deprived areas are attending A&E services for their mental health at 3.5 times the rate of people from the least deprived areas.
CQC remains concerned that a lack of suitable community resources continues to lead to inappropriate hospitalisation of people with a learning disability and autistic people, although our early work on Independent Care (Education) and Treatment Reviews has seen people move out of long-term segregation.
The regulator is calling for national action to tackle system-wide issues in community mental health. Better funding, improved community support, and a specialised and sustainable workforce is needed to ensure that people receive the care they need.
Interim director of mental health at the Care Quality Commission, Jenny Wilkes said:
“These issues will be all too familiar to people in mental health crisis, and their loved ones. We urgently need more community support and a better understanding of people’s needs to reduce the number of people being detained. And we know the situation is even starker for people from deprived areas, people from ethnic minority groups, autistic people and people with a learning disability. While the Mental Health Bill aims to address inappropriate detentions and improve mental health care, this can’t be addressed by legislation alone as there simply aren’t the resources to fix these issues.
“Without timely access to necessary mental health support, people may find themselves being bounced from service to service without ever receiving the level of care that they need. This is a particular concern for children with mental health needs who risk missing out on school and their social life, and carrying their trauma and feelings of isolation into adulthood.
“It is essential that the government addresses these significant gaps now to protect people for the future. With the right funding, a sustainable and well-trained workforce and enough beds to meet demand, we can break this damaging cycle.”
