A Qualitative and Group Concept Mapping Study to Investigate Service Users’ Perspectives on Strengthening Integration Between Mental Healthcare Services in England

Background Integrating mental health and social care services is essential for improving access to quality mental healthcare and for addressing the wider determinants of poor mental health. The UK’s National Health Service, together with its social care and voluntary sectors, is currently undergoing a transformation to achieve this. However, many service users report a lack of integration, long waiting lists, and services that focus on treating symptoms rather than taking a holistic approach. This study aimed to inform an integrated whole system approach to improving mental healthcare and reducing mental health inequalities, from the perspective of service users. Methods We used Group Concept Mapping (GCM) and one-to-one interviews to collect and synthesise the views of 55 service users on integration in the mental healthcare systems in two regions of England. GCM data from the first workshops were analysed using multi-dimensional scaling and hierarchical cluster analysis to create group maps which were then merged into concepts. Interview data were analysed using Framework Analysis which allowed for incorporation of the GCM concepts into the coding framework. Findings were used to form the focus of discussions at the second GCM workshops to produce recommendations. Results Service users described the mental healthcare system as fragmented, opaque, and difficult to navigate—particularly during periods of acute need. Many reported limited awareness of what services were available, how to access them, or what to expect. Service users emphasised the need for a more holistic approach that goes beyond symptom management to address the wider determinants of mental health. We identified 7 recommendations to address some of these issues, which included better information sharing, more connected link workers, and greater provision of tailored community support groups. Further recommendations focused on community hubs, directories of services, and embedding experts by experience and mental health workers across the system. Conclusions Service users want a more connected, navigable, and holistic mental healthcare system—anchored by shared information, consistent support, and community-based care that addresses the wider determinants of mental health. Future work should explore ways to implement our recommendations and evaluate their impacts on mental health support.