'Fearful, Anxious and Unable to Speak': Hidden NHS Report Reveals Toxic Culture at Major Mental Health Trust

A National Health Service (NHS) report found a deeply 'toxic' work environment at Mersey Care NHS Foundation Trust where the staff work in fear of the senior leaders. Some of the workers said they were 'fearful, anxious and unable to speak openly' because of leadership behaviour.

The relationship between senior leaders and staff was described as 'adversarial and distrustful,' with officials thought to succumb to favouritism and nepotism often. The internal politics created 'a divisive and toxic culture' often described as 'dysfunctional.'

Psychological Toll on the Mental Healthcare Workers

Ironically, the very staff working to provide mental health services are now subjected to a 'pervasive culture of anxiety.' The review was commissioned by NHS England in June 2025, at the request of former trust chief executive Trish Bennett and then-chair Rosie Cooper.

'There is a clear lack of psychological safety among board and senior leaders, with staff feeling fearful, anxious and unable to speak openly,' the review stated. It also found 'key sources of tension and instability, with relationships described as adversarial and mistrustful, fostering a divisive and toxic culture.' The politics within was also 'seen to detract from patient care, operational performance and staff wellbeing.'

Mersey Care operates a specialised mental health trust serving at least 1.4 million people who have learning disabilities, addiction, brain injury and more. The trust has facilities across the North West of England and is the largest provider of services for children and teens across Liverpool and Sefton.

The trust employs 11,000 people. On its website, Mersey Care says: 'We support our staff to do the best job they can and work alongside service users, their families and carers to design and develop future services together.'

Why the Report Has Only Surfaced Now

The report, which was commissioned in June 2025, was released in November 2025. It was never made public until this month, when the Health Service Journal made a request citing the Freedom of Information Act. The trust said it is working urgently to improve the work environment at Mersey Care.

According to reports, some of the non-executive directors left Mersey Care following the internal release of the report. Cooper also stepped down, although health was the official reason cited for the resignation.

'We are committed to learning, openness and continuous improvement and welcomed the independent leadership and culture review undertaken last year as an important opportunity to reflect and identify where we can further improve,' the trust's statement read. 'The review highlighted several areas to build on, and the Trust acted swiftly to strengthen Board arrangements, enhance governance and decision-making and further embed the leadership behaviours and standards expected across the organisation.'

The trust has created a mechanism where the staff can freely share feedback and concerns, as well as recommendations to help improve the organisation. Further, Mersey Care is implementing activities that will open communication between senior leaders and workers, such as forums, open dialogues and listening events, focusing on ensuring the staff 'feel safe to speak up, know they are listened to and are treated with dignity and respect.'

The NHS Council of Governors also appointed Sheena Cumiskey MBE as the new Mersey Care chair. Cumiskey was appointed in April but officially took the mantle this month.