Letter: Recycle money for community care

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The Independent Online
Sir: Dr Stephanie Chadwick ('The muddle over mental illness', 6 October) estimates that almost 200,000 adults in England have severe mental illness. Research conducted by the Mental Health Foundation shows that this is an underestimate. The figure is probably more than two million. She goes on rightly to highlight the lack of hospital beds for people who are seriously ill.

All too often, however, we hear the programme to close long-stay hospitals blamed for the apparent increase in vulnerable homeless people who are not receiving the treatment and care they need.

The facts do not support this assertion. Research in central London into the causes of homelessness among people who are mentally ill finds no link between the closure of hospitals and their homelessness and inability to access treatment and care services. In fact, 24 per cent became homeless on losing their local authority tenancy.

The evidence points to the problem being the uncoordinated and inadequate approach to the provision of services in the community and the low level of acute short-stay psychiatric beds in general hospitals.

The Mental Health Foundation welcomes Virginia Bottomley's statement last week that the Government has a long-standing commitment to funding community care fairly and properly.

Community care has to be resourced properly - the cost of not doing so is too high.

However, this does not necessarily mean that it is all additional money that has to be found. Recycling existing money and the better co-ordination of services would go a long way towards meeting the need.

For example, the Department of Health ought to be making a direct contribution to the Housing Corporation to support the development by housing associations of more community care schemes, reflecting at least the value of land released by hospital closures.

GPs, social services and acute hospital beds should all be receiving increased funding from health authorities which, we estimate, save at least pounds 20,000 a year for every long-stay bed that closes.

Extra money is undoubtedly needed. But Mrs Bottomley may find that the additional cost is not as high as it might be if she also persuades her colleagues to plan for a more effective co-ordinated redistribution of resources and the sharing of responsibility for community care.

Yours faithfully,



Mental Health Foundation

London, W1

8 October