Deadline set for mental care improvements

PATRICIA WYNN DAVIES

and GLENDA COOPER

The Government will today set a three-month deadline for health authorities to improve the treatment and supervision of mentally ill people in the community in the wake of two influential reports spotlighting markedly different standards of care across the country.

Today's publication of the reports will coincide with the despatch of a strongly-worded letter from Gerry Malone, the health minister, to the 100-plus authorities calling for "substantial progress" to be made by November.

The two reports, one from the Clinical Standards Advisory Group committee on schizophrenia and the second on the Care Programme Approach (CPA) from the Social Services Inspectorate, follow a letter to authorities from Stephen Dorrell, Secretary of State for Health, earlier this month, when he said: "There is widespread agreement about the shape of services to deliver proper community-based care for mentally ill people. What has too often been lacking is the will to deliver. It is for health authorities to ensure that fine words about mental health services are converted into fine actions."

Mental health charities and health authorities warned yesterday that the three-month deadline would be "unrealistic" unless the Government pledged further funding for services.

Mr Dorrell gave the go-ahead for Mr Malone to deliver a further rebuke in the light of the reports' findings that standards are still "patchy" across the country nearly four years after health authorities took on lead responsibility for care in the community. Government sources say Mr Malone is satisfied that some authorities are delivering, but is concerned over the lack of high standards across the board.

The action will inevitably provoke criticisms that the Government provides only direction, while neglecting the need for adequate resources and problems with co-operation from other agencies. Mr Malone insists that the difficulties stem from factors such as poor management and organisation, and in some cases sheer "lack of will". His letter is expected to highlight the provision of resources for severely ill people and call for better mental health information systems, including supervision registers, and better management, training and supervision of staff.

Only last month the annual report of the Social Services Inspectorate's Chief Inspector, Herbert Laming, revealed widespread failure to implement the Care Programme Approach - the drawing up of appropriate care plans - for people leaving psychiatric hospitals.

Grainne McMorrow, legal consultant for Sane (Schizophrenia - A National Emegency) said calls to the organisation's helpline showed that care across the country was "inconsistent and unequal", but added: "I imagine problems will revolve around inadequate financial resources and inadequate staffing levels."

But there was a welcome for Mr Dorrell's decision to make mental health a priority. Chris Prior, director of the Mental Health Foundation, said his ``first major action as health secretary has been to prioritise mental illness and take health authorities to task. There has been too much fudging and it's an excellent move forward."

Mr Dorrell's strategy of selecting specific priorities stands in contrast to the much more unstructured approach of his predecessor, Virginia Bottomley.