The mental health landscape is changing rapidly, and the potential for improvements in access, care pathways and patient autonomy comes across clearly from these valuable insights from colleagues across the sector.

However, the opportunities are accompanied by real challenges in key areas that can be summarised as:

  • Successful transition from hospital to community care requires structural change, effective co-ordination, clear accountability and public buy-in. Traditional clinical services, and established public assumptions, are premised on those with significant mental health needs being accommodated in hospital, with or without their agreement. Community services as an alternative will work only with pre-emptive and carefully focused local support.
  • Delivery of improved care pathways, be it for children or those with complex physical and mental health needs, requires improved integration. Joint working, including pooled funding where necessary, between NHS providers, local authorities, independent and third-sector agencies, schools, carers and communities, is essential if the drive to safe, resilient community services is to succeed.
  • Resources are the elephant in the room. Moving patients to supportive community settings, reducing compulsion and responding to the explosion in need for child and adolescent mental health services require focused funding in the right place at the right time. Short-term savings based on restricting access to services such as advocacy, or the repeated retendering of services, risk limiting long-term cohesion and progress.

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