The Care Quality Commission (CQC) has called for a ‘system-wide approach’ to mental health care, warning that people are becoming more unwell while waiting for assessment and that pressures on services are worsening inequalities.
Published on 29 January, the regulator’s annual report on the use of the Mental Health Act said rising demand and constrained capacity were contributing to longer waits for assessment and treatment.
The result was that patients’ mental health worsened and they were often sicker by the time they were admitted to hospital, said the report, which is based on interviews with over 3,000 patients and over 700 family members and carers.
CQC said pressure across the pathway continued to be seen in inpatient capacity, with the average mental health overnight bed occupancy rate remaining above the recommended 85% threshold at 90% in 2024/25.
Alongside delays, the regulator highlighted persistent inequalities.
It found that in 2024/25, people of Black or Black British ethnicity were over eight times more likely to be subject to a community treatment order than people of White British ethnicity.
And people living in the most deprived areas were 3.6 times more likely to be detained under the MHA than those in the least deprived areas.
In addition, during 103 monitoring visits between January and March 2025, staff in more than three-quarters (77%) of services said they had not heard of Patient and Carer Race Equality Framework (PCREF), which is now mandatory across mental health trusts and service providers who receive NHS funding.
The report also found that out-of-area placements remain a persistent problem, with 5,649 placements started in 2024/25 outside a patient’s local area – a 5% rise on the previous year.
It added that while many services ensured staff had completed mandatory training in learning disability and autism, some staff – particularly agency and bank staff – lacked the skills required, with patients reporting they felt unsupported or spoken to in ways that felt undignified.
The regulator called for ‘a system-wide approach to improve mental health care’.
Chris Dzikiti, interim chief inspector of mental health at CQC said there was ‘a long way to go’ to meet the needs of people struggling with their mental health.
Gemma Byrne, policy and influencing manager at Mind, said the report showed a ‘continued downward trend’ in the quality of mental healthcare and patient outcomes.
‘This is unacceptable for both people with mental health problems at their lowest point, and the many staff who are trying their very best to deliver compassionate care in the most challenging environments,’ she said.
The report comes after the Mental Health Bill received Royal Assent on 18 December 2025, amending the Mental Health Act 1983.
Health Secretary Wes Streeting said the new act would ‘transform lives’ and ‘bring mental health care into the 21st century’.
The Department of Health and Social Care was contacted for comment and referred us to the new Mental Health Act.
NHS England has been approached for comment.
