Mental health services

Mental health services range from primary care mental health teams working with GPs to inpatient wards for people who are held for compulsory treatment.

In England, services are currently commissioned by primary care trusts (PCTs) and provided by specialist mental health trusts or voluntary sector agencies. In Scotland, Wales and Northern Ireland, NHS mental health services are part of the general provision by Health Boards or Health and Social Care Trusts.

In England, Scotland and Wales, the NHS is required to plan and work with their local authority social-care department in the provision of care to people with mental health problems. In Northern Ireland, health and social care are provided by the same organisation.

In some larger HIV clinics there may be specialist psychologists, mental health nurses and even psychiatrists who are part of the multi-disciplinary team or have a specific interest in working with people with HIV. Primary care trusts (PCTs) or Health Boards may also fund (commission) voluntary agencies to provide support to people with HIV. Elsewhere, people with HIV may be referred to general mental health services for specialist advice and support.

In addition, a number of voluntary sector charities for lesbian, gay and transgender people and immigrants provide free counselling and support services. Private counsellors also provide services to paying customers across the UK and some will provide discounted services for people on a low income. The British Association for Counsellors and Psychotherapists runs an accreditation scheme and provides a directory of accredited practitioners in the UK.

Yes. Specialist mental health services generally require a referral from an HIV clinic or a GP. Charities working in mental health and private counsellors may be open access and not need a referral.

Yes. People need to live in the area covered by the NHS organisation or the local authority.  Charities may accept people from other areas.

NHS services are usually free of charge. There may be charges for other services.

When provided in an NHS hospital or by hospital staff, the rules are the same as for secondary care (see above). People detained under the Mental Health Act cannot be charged for their treatment. Local authority mental health care follows the rules of social care (see below).

People eligible for NHS care are entitled to a mental health assessment. People who require aftercare services when they have been released, after being compulsorily detained under the Mental Health Act, are entitled to free care regardless of income and this can include accommodation in a care home. The outcome of the assessment will define what NHS and social-care services they are able to access.

There is a long established movement to provide a voice for patients and improve mental health care. It often works with local agencies of the charity Mind (www.mind.org.uk).