Why is it so hard to access mental health support in County Durham?
Voices from the ground
The Lived Experience Team at TEWV NHS Foundation Trust has spent years listening to service users across County Durham. Their stories highlight the human impact of system inefficiencies.
One resident waiting for an ADHD diagnosis described receiving a letter threatening removal from the waiting list if she missed a phone call, leaving her “terrified of starting over.” Another individual involved in crisis services has been using his experience to help shape improvements for future patients.
Service providers also report frustrations. Inconsistent attendance at multi-agency meetings, unclear referral processes and lack of communication between services often leave staff unsure of where to direct patients. Some describe being used as a “dumping ground” for complex cases, while others report that patients are passed between services without proper communication or follow-up.
The barriers to access
Analysis from the Healthwatch report shows several recurring challenges:
- Complex referrals: Long, repetitive forms and unclear criteria mean many practitioners bypass formal pathways and contact services directly.
- Gaps in care: Individuals with moderate-to-high needs often fall between primary and secondary care, receiving insufficient support.
- Communication issues: Feedback loops are missing, attendance at collaborative meetings is inconsistent and understanding of service roles varies widely.
- Resource pressures: Staff burnout, high turnover and limited VCSE capacity reduce service availability and continuity.
What’s working (and where progress has been made)
Despite these barriers, the transformation has led to notable successes:
- Collaboration: Bringing statutory and voluntary services together has strengthened relationships and awareness of available support.
- Networking and learning: Huddles, Gateway pathways and link worker networks provide opportunities for shared knowledge and problem-solving.
- Service user input: The Lived Experience Team ensures that patient voices influence planning and improvements, creating more person-centred care.
TEWV’s response and improvements
TEWV NHS Foundation Trust has acknowledged the challenges and implemented changes over the past year:
- Increased capacity: Restructuring of community services has improved access to psychological therapies, with 96.9% of adult mental health patients receiving assessments within four weeks of referral.
- New workforce roles: Clinical Community Pharmacists, Peer Support Workers and Mental Health Wellbeing Practitioners have been introduced, alongside enhanced primary care support.
- Positive patient feedback: Surveys indicate high satisfaction, with 91% rating adult mental health services as good or excellent. Patients report feeling treated with dignity, respect and involvement in care decisions.
Moving forward: Recommendations for change
Service providers and Healthwatch recommend:
- Simplifying access: Streamline referrals, provide a shared directory and reintroduce multi-agency huddles with mandatory attendance.
- Focusing on continuity: Reduce waiting times, prevent service users from being bounced between services and provide a single named contact for each person.
- Expanding support for complex needs: Create dedicated pathways for individuals who fall between primary and secondary care.
- Strengthening community involvement: Include more lived experience voices in planning, delivery and evaluation.
- Supporting staff and leadership: Invest in workforce wellbeing, retention and consistent leadership across organisations.
While progress has been made, the transformation has exposed the complexity of mental health care in County Durham. Simplifying pathways, improving communication and embedding person-centred approaches remain essential to ensure every resident can access the support they need.
Have your say
Access to mental health support affects thousands of people across County Durham. While improvements have been made, our Community Mental health Transformation Evaluation report shows there is still more to do to ensure services are easy to access, joined-up and person-centred.
If you have experience of using adult mental health services, whether positive or challenging, we want to hear from you. Your feedback helps shape local services and holds decision-makers to account.
Share your experience with us today or sign up to our newsletter for updates on how services are changing
Together, we can help make mental health support work better for everyone in County Durham.