No wrong door: a vision for mental health services in 2032
12 December 2022
Our vision for what mental health, autism and learning disability services should look like in ten years’ time, for people of all ages in England.
Mental health
Integration
Cross-sector partnerships
Key points
- Mental health, autism and learning disability services need to change. This report sets out a vision for what these services should look like in ten years’ time, for people of all ages in England.
- Commissioned by the NHS Confederation and written by Centre for Mental Health, the report brings together research and engagement with a wide range of stakeholders, as well as people who bring personal and professional experience about what these vital services should be like in 2032.
- It identifies ten interconnecting themes that underpin the vision and three key requirements that would turn the vision into reality.
- While there have been many vision statements for mental health, autism and learning disability services over the years, few are ever realised in practice. This report explores what might help and what could hinder the vision, calling for action on funding, workforce and reform to enable faster access to care.
- As the case studies featured in this report show, every element of the vision is already a reality somewhere in England. The ambition is to see it realised everywhere.
- By making the changes outlined here and investing in the vision, people’s lives can be improved immeasurably.
Summary of our vision
Mental health, autism and learning disability services need to change. In ten years’ time, our vision is that these services will look very different in the following ways:
Prevention. In 2032, greater effort will be made to protect and promote our mental health throughout every stage of life and to ensure autistic people and people with learning disabilities are properly supported to have fulfilling and independent lives. Locally and nationally, government and public services will take a systematic ‘population health’ approach to reducing the social and economic risk factors for poor mental health and boosting protective factors in individuals, families and communities.
Early intervention. In 2032, services will not wait until someone is in crisis to offer help. Instead, early intervention will be the norm, with support front-loaded at an early stage to prevent more serious difficulties developing later on. Services will meet people where they are at, including online, at school, and in community spaces where they feel comfortable.
Access to quality, compassionate care. In 2032, there will be no wrong door for anyone seeking support for mental health, autism and learning disability needs. People will be able to present at any point in the system – from pharmacies, advisory services and community groups to education, social services, the criminal justice system and primary care – and get the right support.
Seeing the bigger picture. In 2032, mental health, autism and learning disability services will see the big picture as they support people to live their lives. People will get support with what matters most to them and services will help people with money, work and housing – with a package of support that is not limited to ‘healthcare’ per se.
Whole-person care. In 2032, services will support people with their physical and mental health and social needs together. Services will treat people as a whole person, being mindful and respectful of their needs, assets, wishes and goals.
Equality focus. In 2032, mental health, autism and learning disability services will be proactive in addressing structural inequalities and injustices. They will understand and challenge the intersecting inequalities that underpin the unequal risks of poor wellbeing and the subsequent inequities in access to support, experiences of services, and outcomes achieved.
Co-production. By 2032, there will have been a shift in the power imbalance between people who use mental health, autism and learning disability services and the organisations that provide them. Co-production as an equal partnership will be the norm in the design, development and delivery of services.
Autonomy, human rights and community support. In 2032, service users will be reaping the benefits of a major investment in community support. As changes to the Mental Health Act will have channelled investment away from institutional and inpatient services, comprehensive support in the community will have risen up to meet people’s needs.
A stronger workforce. In 2032, there is a thriving workforce of clinicians, mental health professionals, allied professions, multidisciplinary teams and diverse experts. Resources have been put in place to buy enough of people’s time and recruit those with the requisite skill levels. Coherent workforce planning has secured this capacity for the long term.
Outcomes that matter. In 2032, services at all levels will be holding the outcomes that matter to service users as their lodestar. They will be able to measure these outcomes and be held to account for them. The system will no longer be driven by the outputs that matter to institutions, but by the outcomes that matter to people.