The Healthcare Commission carried out a survey in 79 NHS trusts which provide secondary mental health services, of more than 19,000 people using those services. This is the third year survey of users of mental health services. More people said that NHS staff were treating them with dignity and respect. But improvements are needed in out-of-hours crisis care, talking therapies and the amount of information given to people who use services. The survey shows that 77% of service users rated their overall care as excellent, very good or good, while 9% rated their care as poor or very poor.