There has been a “concerning” drop in people’s satisfaction with NHS mental health services, with one in five of those in crisis not getting the help they need, a regulator has warned.

The Care Quality Commission (CQC) published its annual survey of NHS community mental health services in England and described people’s experiences as “poor”.

It comes just a week after the CQC warned that maternity services across England have deteriorated to their lowest level.

The new mental health poll, of 13,418 people who received treatment between September and November last year, found that of 13 questions on key areas, eight had reported their lowest result.

Seven areas also showed a “significant downward trend” in satisfaction across the last five years.

An NHS spokeswoman said mental health services are treating far more people than before the pandemic.

The latest results showed that four in 10 (40%) people said they had not had a care review meeting in the past 12 months, almost a third (31%) have not been told who is in charge of their care, and less than half (48%) thought the person they saw was aware of their treatment history.

When it comes to accessing care, there has been an 11 percentage point decrease since 2014 in the number of people stating they were “definitely” given enough time to discuss their needs and treatment.

Overall, 45% of people were not always given enough time to discuss their needs.

Similarly, there has been an eight percentage points drop in the number of people feeling that they have “definitely” seen NHS mental health services enough for their needs. Just 40% of people said they had “definitely” seen services enough.

Meanwhile, two in five people (44%) also thought the waiting time for NHS talking therapies was too long.

When it came to crisis care for the acutely unwell, 28% of people said they would not know who to contact out of hours in the NHS if they had a crisis.

Almost a quarter of people in crisis either did not get the help they needed (22%) or could not contact services (2%).

Less than half (47%) reported that they “definitely” got the help they needed.

Meanwhile, 19% of people felt they had to wait too long to get through to a crisis worker or team.

The CQC said there were few areas of care where the majority of people reported good experiences.

Chris Dzikiti, director of mental health at the CQC, said: “It is hugely concerning that we have seen year-on-year deterioration in people’s experiences of NHS community mental health services.

“We have seen how services can adapt rapidly to deal with extreme pressure, but sadly these are only likely to increase, with typical seasonal pressures amplified by Covid-19 and a cost-of-living crisis that could impact on people’s mental health.

“Poor access to services risks people reaching crisis point, leading to being admitted to environments that don’t support their recovery and risk their mental health deteriorating.”

Overall, the report said that people who received their care via telephone, younger people (aged 18 to 35), and those with more challenging and severe non-psychotic disorders were less likely to report positive experiences.

It comes as separate data from NHS Digital shows a 6% drop in the number of detentions under the Mental Health Act in England in the last year.

In 2021-2022, 53,337 new detentions were recorded, though not all providers submitted data.

An NHS spokeswoman said: “As the CQC acknowledges, mental health services are facing record demand – at the time this survey was conducted, 117,000 more people were referred for support compared to before the pandemic – yet it is encouraging that around nine in 10 people reported positively on the NHS staff member who was organising their care.

“NHS mental health community services are undergoing significant transformation in line with the Long Term Plan commitment of investing £2.3 billion a year, and the people who use these services will be key to deciding how this is delivered.

“So if you are struggling with your mental health please come forward for care – either via nhs.uk where you can refer yourself to our talking therapy service, or through crisis lines available 24/7, with both services helping hundreds of thousands of people every month.”

Lucy Schonegevel, associate director of policy and practice at Rethink Mental Illness, said: “Every person represented in these statistics is someone whose life has been put on hold due to severe mental illness, and it’s frustrating that the number of people being detained remains so high.”