Common weaknesses included a failure to work with social services and GP fund-holders in drawing up mental health strategies.
The Government's review of mental health care around the country was set up in August 1995, after two highly critical reports by the Clinical Standards Advisory Group and the Social Services Inspectorate labelled care in the community "haphazard" and "confused".
The results published yesterday show that 33 health authorities will not be able to improve their service until the end of 1996 -7. Blackspots around the country included the North Thames region, where not one health authority could be said to be currently providing a "comprehensive adult mental health policy" and two thirds will not achieve this by the end of 1997, according to a confidential report leaked to the Labour Party.
The review, produced by Ros Levenson, Regional Mental Health Co-ordinator for North Thames, revealed that there was "a range of attitudes from anger to despair to desperation".
The report said there was a "sense of fear" about the impact of reducing management costs. "The policy changes that have increased the use of diversion from courts or elsewhere were perceived as putting health services under strain without resources necessarily meeting the increased demand ".
There was a perception that London in general and inner London in particular had significant health problems, which were not reflected adequately in resource allocation. Recruitment was a problem at all levels and staff were reported to be under "considerable strain".
Harriet Harman, the shadow Health Secretary, said: "The Government has failed to ensure that mentally-ill people get the care they need when they need it. The price is paid by the mentally-ill themselves and by the communities in which they live."
The Government's report says health authorities have responded "extremely positively" to the need to increase secure psychiatric provision. Around 1,200 purpose-built medium secure beds will be in place by March 1997. A further 450, many of which are of medium secure standard, are provided in "interim secure units and approximately 300 more are included in current development plans. About 400 secure places are purchased from independent sector providers.
Pressure is unevenly distributed across health authorities with the four inner London health authorities - Camden & Islington; Kensington, Chelsea and Westminster; Lambeth, Southwark and Lewisham; East London and City - responsible for the purchasing of 17 per cent of the total number of secure beds.
Mr Dorrell said the review confirmed every health authority now had in place plans committing it to deliver a comprehensive mental health service.
"Although the phrase 'care in the community' has gone into the language it's actually an inaccurate description of our mental health policy," he said yesterday "It's not our policy to provide care simply in the community for people who are mentally ill."
AUTHORITIES WHICH NEED TO IMPROVE
Health authorities whose plans require service improvements beyond the end of 1996-97 to deliver comprehensive mental health services are:
Bury & Rochdale
East London and City
Exeter and North Devon
Redbridge & Waltham Forest
St Helens & Knowsley
Wigan and Bolton
Wiltshire & BathReuse content