A Community Mental Health Team, usually shortened to CMHT, is the part of the NHS that looks after people whose mental health needs are too complex or long-term for a GP or a talking-therapies service to manage alone. In London the picture is complicated by scale: the capital’s mental health trusts each cover several boroughs, and how a CMHT is organised, and how someone reaches one, varies noticeably depending on which side of a borough boundary a patient happens to live.
For a city-wide review interested in provision and access, that variation matters as much as the service itself. A resident in one borough may be referred into a single team covering the whole area; a resident a few streets away, in a different trust’s catchment, may be routed into a neighbourhood-specific team or a "hub" model instead. Understanding how CMHTs are staffed and accessed is the starting point for understanding why access to community mental-health care in London is so unevenly experienced.
What a Community Mental Health Team actually does
CMHTs provide ongoing, community-based support for adults with severe or complex mental health conditions, including conditions such as psychosis, schizophrenia, bipolar disorder, moderate-to-severe depression, eating disorders and personality disorders where risk or complexity means primary care alone is not sufficient. Support is typically longer-term than a course of talking therapy, and can include medication management, care coordination, home visits and support with daily living, alongside help for carers, family members and friends who are also affected.
CMHTs are deliberately multidisciplinary. A typical team brings together psychiatrists, mental health nurses (often described as community psychiatric nurses), clinical psychologists, occupational therapists, social workers, support workers, approved mental health professionals and, increasingly, peer support workers with lived experience of mental illness. Pharmacists and employment support workers are also commonly attached to teams, reflecting the fact that recovery in the community usually depends on more than clinical treatment alone.
How someone actually gets referred
Access into a CMHT is almost always via referral rather than self-referral. The most common route is a GP assessing that a patient’s needs exceed what primary care or NHS Talking Therapies can offer, and referring them on. Referrals also arrive from other health and social care professionals, and from other parts of the mental health system: a home treatment team, a hospital discharge process, or a specialist triage service may all transfer a patient into ongoing CMHT care.
Crisis access follows a different path. Someone in an acute mental health crisis is directed to NHS 111, A&E, or 999 rather than straight to a CMHT, with crisis teams then deciding whether onward referral to a CMHT is appropriate once the immediate risk has been managed. This two-track structure — a planned referral route for ongoing complex needs, and a separate emergency route for acute crises — is one of the more consistent features of the system across London, even where the teams themselves are organised differently.
Why the borough you live in changes the shape of the team
London does not have one CMHT model; it has several, because each NHS mental health trust covers a different footprint of boroughs and has organised its community teams to fit local geography and demand. A few examples illustrate the range:
| Trust | Boroughs covered | How CMHTs are organised |
|---|---|---|
| South London and Maudsley NHS Foundation Trust | Includes Southwark | Multiple CMHTs within a single borough — for example, separate teams for Borough, Bermondsey and Rotherhithe, Walworth, and Camberwell and Peckham |
| North London NHS Foundation Trust | Barnet, Camden, Enfield, Haringey, Islington | Care delivered across five boroughs under one trust structure |
| Central and North West London NHS Foundation Trust | Includes Brent | Organised as local "hubs," with the hub a patient attends set by their GP practice |
| East London NHS Foundation Trust | Includes Tower Hamlets | Some CMHTs, such as Bow and Poplar, are transitioning into Neighbourhood Mental Health Teams |
| South West London and St George’s Mental Health NHS Trust | Wandsworth, Kingston, Merton, Richmond, Sutton | Adult CMHTs run alongside separate Child and Adolescent Mental Health Services in each borough |
The practical effect is that "access to a CMHT" is not a single, uniform offer across the capital. It is a patchwork of trust-level structures, each with its own team boundaries, its own hub or neighbourhood arrangement, and its own relationship with local GP practices. A resident’s actual experience of community mental-health provision — how quickly they are seen, how the team is named, and how continuity of care is managed if they move address — depends heavily on which of these local models they fall under.
Why this matters for a city-scale view of provision
The 2014 case for reform behind this site set out a vision of care that follows the patient rather than the institution, delivered as close to home as possible and integrated with GPs, councils and the voluntary sector. Community mental-health teams are one of the clearest tests of whether that vision has been realised in practice, because they sit exactly at the boundary between primary care and specialist treatment. Where CMHT structures differ sharply from one trust to the next, so does the lived experience of provision, even for patients with clinically similar needs.
Conclusion
Community Mental Health Teams remain the backbone of ongoing care for Londoners with severe or complex mental illness, staffed by a genuinely multidisciplinary mix of clinicians and support workers, and reached almost always through a GP or professional referral rather than directly by patients themselves. But because each mental health trust in London has built its own version of the CMHT model — single borough-wide teams in some areas, hub arrangements in others, neighbourhood teams emerging elsewhere — provision is not consistent across the city. Any assessment of London’s community mental-health access has to start from that basic fact: the team a patient is referred to, and how that team is organised, depends first and foremost on their postcode.