Sir: The Clunis Report cited the serious breakdown of communication between agencies as a key contributory factor in the killing of Jonathan Zito. Eighteen months on, agencies with no clearly defined roles are still engaged in a lethal game of buck-passing, while services remain unmonitored.
The report into the Jonathan Newby case ("Breakdown of care led to killing", 27 July) levels criticism at both the Oxford Health Authority, for lack of investment in services, and at the social services department, which was "notable by its virtual absence". When agencies fail to liaise, and are unclear about accountability, the people with the most serious need of care, such as John Rous, continue to be the responsibility of the least- trained people, sometimes with disastrous consequences.
Residential care, in particular, is an area where disasters are waiting to happen. Many people with serious mental-health problems are being looked after in residential care, much of which is provided by the voluntary or private sector. Standards vary enormously: some voluntary-sector services are excellent, others are less so. Jacqui Porter House, according to the report, was under-resourced, understaffed, and run by poorly trained staff with little understanding of the risks involved in caring for the mentally ill. Most significantly, in the Newby case no professional support was forthcoming from services set up to provide it.
Legislation has addressed many of the issues relating to individual sectors, but cross-sector responsibilities have been left to local managers to decide, at a time when low resources are unlikely to encourage them to take on new tasks. Community care will only succeed when one individual is identified as responsible not only for coordination, but also for leadership across sectors.
Sainsbury Centre for Mental Health
27 JulyReuse content