Mental health patients in the UK are routinely coming to harm because of high caseloads, understaffing and overwhelming administrative work, according to a poll that found only a fifth of specialist nurses felt their workload was manageable.

Prof Nicola Ranger, the general secretary of the Royal College of Nursing, said mental health nurses were caught in a “perfect storm” and unable to keep up with rising demand, with patients paying the price by missing out on crucial care.

Half of the specialist nurses who responded to the RCN union’s UK-wide survey said mental health patients “frequently come to harm” because caseloads are too high, with a quarter feeling that time pressures lead to daily issues with patient deterioration, relapse or self-harm.

Nearly two-thirds said their caseloads had risen “a lot” in the past three years, while excessive admin and a “tick box” culture were blamed for taking away valuable time for patient care. The poll also suggests that demand for services has grown more than twice as fast as the number of nurses in the field.

“With too few staff, overwhelming caseloads and excessive admin, community mental health nursing teams are caught in a perfect storm,” Ranger said. “It means that despite working exceptionally hard, they just cannot meet rising demand.

“The result is vulnerable people with mental ill-health going without care and nursing staff feeling deeply distressed as patients deteriorate.”

Between October 2022 and 2025, the number of people in England alone accessing community mental health services rose 38%, from 499,730 to 689,769, the RCN said. Over the same period, the nursing workforce rose 15%, from 20,171 to 23,280. Only 12% of nurses who answered the poll said they had enough time to care for their patients.

One respondent said vulnerable patients who reached out for help from her NHS trust would often wait weeks for a response and sometimes not be contacted at all. Echoing other respondents, another nurse told the RCN: “It is incredibly dangerous and I await the day I am called to a coroner’s court.”

The warnings add to concerns raised by the Care Quality Commission, which reported in March that a third of people seeking mental health care wait at least three months for an appointment. Meanwhile, half of those who contacted crisis services for children and young people did not get the help they needed.

Ranger said growing the “crucial workforce” must become a government priority and called for “sustained and significant investment” in community mental health nursing. Investment in digital infrastructure is also required, the RCN said.

Tom Pollard at the mental health charity Mind said the research exposed the “huge pressures” facing frontline mental health workers, adding: “It’s clear staff are trying to deliver high-quality mental health care, but growing demand, higher caseloads and administrative burden means this is increasingly a struggle.

“People need timely, high-quality care, delivered by professionals who are not overstretched,” he said. “Without that, their safety may be at risk, and they will be less likely to recover. Mental health services need to be better designed, staffed and funded. This starts with the UK government making timely and high-quality mental health care a higher priority.”

A Department of Health and Social Care spokesperson said community mental health nurse numbers had increased by 26% since July 2024. They added: “There is much more to do, which is why we are investing a record £16.1bn in mental health services this year, reforming the Mental Health Act for the first time in decades, hiring thousands more mental health workers and upgrading mental health infrastructure to make it fit for the future.”