Better supervision of mentally ill 'to cost pounds 500m': Schizophrenia charity says many more nurses and beds needed under package of care improvements

IMPROVEMENTS to the supervision and control of mentally ill patients after they are discharged from hospital, due to be revealed next week, will cost pounds 500m a year, according to the National Schizophrenia Fellowship.

The charity, which represents people with schizophrenia and their carers, said this would be the cost of changes to the 1983 Mental Health Act reported yesterday. Although the Department of Health refused to confirm the details, it was reported that there would be three key changes that would involve tighter restrictions on patients from hospital; closer supervision and tracking of individuals after discharge; and the introduction of supervised discharge orders so patients failing to take medication can be forcibly readmitted to hospital.

The changes follow a review of the Mental Health Act ordered in January by Virginia Bottomley, Secretary of State for Health, after Ben Silcock, a schizophrenic, was mauled when he climbed into the lions' den at London Zoo. Pressure on the Government to act increased after more high-profile cases, including that of Christopher Clunis, a paranoid schizophrenic who killed Jonathan Zito on a London railway station platform.

Martin Eede, the NSF's chief executive, said: 'If the Government really is now going to say that, by law, all severely mentally ill people leaving hospital should have a named key worker who will be responsible for ensuring they receive appropriate care and support in the community, we are delighted . . . But this comes at a cost.'

He said there were 80,000 people in England with severe mental illness who had continuing care needs. All needed a key worker, ideally a community psychiatric nurse. As one key worker can only look after 15 people with severe mental illness this will mean that 5,500 community nurses will be needed solely to look after the severely mentally ill. There are 3,800 such nurses but many deal with other types of cases.

Mr Eede said there would have to be large-scale recruitment, more money for care facilities and thousands more short-stay hospital beds in 'community based havens' for those who required hospital care.

He added: 'We are very pleased if at last we are to have community care that works but it will mean an immediate increase in the budget of pounds 500m. If all the Goverment gives us is more words and more promises without the necessary cash to actually make community care work, then it will be hypocrisy of the highest order.'

Judi Clements, legal director of Mind, the mental health charity, said: 'The Government could improve community care without spending another penny if it closed the outdated Victorian mental hospitals and forced health authorities to spend all the savings on community care services.' The funds made available would allow every part of the country to have hospital places for acute treatment.

Liz Lynne, the Liberal Democrat spokeswoman on community care, said savings from the closure of 70,000 mental health beds since 1979 had not gone into community care.