Leading Article: Whitehall's fiefdoms fail the mentally ill

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The Independent Online
EACH scandal involving community care of severely mentally ill people seems to reveal a similar pattern. Typically, a bewildering array of institutions and professionals - hospitals, housing departments, prisons, psychiatrists, nurses, GPs and social workers - is found to have dealt with a patient. Poor local co-ordination is usually blamed for tragic consequences: last month the Royal College of Psychiatrists reported that 34 psychiatric patients had committed homicide in three years.

Central government has generally escaped criticism, beyond the contested claim that it underfunds mental health services, but yesterday the spotlight was on Whitehall. An inquiry by the Mental Health Foundation showed how government departments are often as much to blame as practitioners on the ground when it comes to dealing with the severely mentally ill.

The deeds of one minister seem to undo those of another. The Home Office runs prison policy without full examination of its impact on mentally ill people, as does the Department of Social Security, the Department of the Environment and so on. One minister's policy can leave individuals homeless, or without benefits, and, not surprisingly, more likely to be drawn into crime and eventual imprisonment.

The inquiry was chaired by Sir William Utting, formerly Virginia Bottomley's chief adviser on social services. He knows how Whitehall works and has called for a Cabinet committee to co-ordinate policy on the severely mentally ill. Sir Roy Griffiths, the architect of community care, argued unsuccessfully that a special minister should co- ordinate the policy. But a comprehensive strategy requires more than a minister attached to a particular department.

Sir William's criticisms have implications beyond the care of the mentally ill. There is increasing evidence that poor communication between government departments undermines the aims of social policy. As the Home Office attempts to reduce crime, the actions of other sectors of government have proved counterproductive. Several studies suggest a link between cutting income support for 16- to 18-year-olds and the number of people in young offender institutions. The rising incidence of school exclusions has also been blamed for delinquency and youth crime. If the Government's policies are to be effective, they must be coherent. That will require it to bridge the gulfs that separate Whitehall's fiefdoms.

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