Letter: Community care needs action, not promises

Sir: The possessed, the lunatics, the mad and the mentally ill have been the property of various remedial agencies throughout history. The founding of Bethlem in the mid-18th century marked the beginning of society's acceptance that something had to be done. A hundred years later the social reformers, led by the Lord Shaftesbury and John Connolly, introduced some humanity by attempting to improve conditions for the sufferers.

The shell-shocked of the First World War forced society at large to see the mad as people not to be simply dismissed. This acceptance gave respectability to scientific research that led to the development of specialist medical services. These included electro-convulsive therapy and insulin coma treatment, which led to the development of psychotropic medication. Enoch Powell in the Seventies began the process of challenging the merits of institutionalisation - a process that eventually led to the concept of care in the community.

Virginia Bottomley is swimming against the tide of progress in attempting to retain the controls of care within the medical world's grasp. Community care should be - and could be - a marriage of the best of medical input and a return to the environmental and, in essence, therapeutic processes that the early social reformers pioneered. Not until the medics accept that the days of their omnipotence are over and that the reins of care should be surrendered to, or at least shared with, the community agencies and the sufferers themselves will the Ben Silcocks have any real hope of a better new year.

Yours sincerely,

BOB CORNELL

Director

Psychiatric Support and After - Care Workshops

Egham, Surrey