The Monitoring the Mental Health Act 2024/2025 report, published on 29 January 2026, draws on interviews with more than 3,000 patients and 700 family members and carers. It paints a concerning picture of a system under strain, marked by persistent staff shortages, a lack of available beds and widely inconsistent patient experiences.
While the regulator acknowledged the dedication and compassion of frontline staff, it warned that long-standing problems continue to undermine care.
The report found that out-of-area placements are increasing, despite a national pledge to eliminate the practice by March 2021. As a result, many patients are being treated far from home, making it harder for families to visit and provide support.
Socio-economic and racial inequalities also remain stark. People living in the most deprived areas are 3.6 times more likely to be detained under the Mental Health Act than those in the least deprived communities. Black people continue to be detained at four times the rate of white people, yet more than half of services inspected had not provided staff with training on racial inequalities.
Alarmingly, in three out of four services visited, staff were unfamiliar with the Patient and Carer Race Equality Framework, a mandatory NHS initiative designed to address racism in mental health care.
Workforce shortages are further compounding the problem. As of March 2025, nearly one in ten posts in NHS mental health trusts remained unfilled, leading to heavy reliance on agency staff. The CQC warned this makes it harder for professionals to build the trusting relationships essential for recovery, de-escalate distress safely and avoid staff burnout. Patients, meanwhile, reported feeling unsafe due to insufficient staffing levels on wards.
The shortage of beds is also forcing people into inappropriate settings, including children being placed on adult wards and patients facing unnecessary restrictions. Some reported being denied access to outdoor space despite it being safe to do so. While some wards were described as clean and supportive, others were recalled as noisy, dirty and distressing, with one parent describing “blood on the walls” and a “disgusting” toilet.
The report also highlighted gaps in staff training to support autistic people and those with learning disabilities, with some patients saying they felt misunderstood or spoken to without dignity.
The CQC is calling for a system-wide response to prevent people from spending months or even years in hospital unnecessarily.
Chris Dzikiti, Interim Chief Inspector of Mental Health at the CQC, said it was “deeply disappointing” to be reporting the same failures year after year.
“Many people detained under the Mental Health Act have exhausted all other care options, yet they still face long waits, with families sometimes forced to supervise them constantly,” he said.
“For Black people, autistic people and people with a learning disability, the barriers to appropriate care are even greater.”
He added that the system urgently needs a larger, better-supported workforce, sufficient beds to meet demand and the right conditions for staff to deliver personalised care.
Despite the challenges, Mr Dzikiti praised mental health workers for continuing to provide compassionate care under pressure and welcomed the revised Mental Health Act, which aims to strengthen patient autonomy and involvement in decision-making.
The regulator said it would work closely with the government and health bodies to help deliver these reforms and improve outcomes for people in mental health care.
