Sir: Marjorie Wallace of SANE (letter, 30 January) over-simplifies the situation in our mental health services. The solution to the problems highlighted in the recent Kings Fund report does not lie in opening more beds per se.
In Lambeth, Southwark and Lewisham in south London, acute admission beds have remained stable in the last few years. The closure of the asylums has cut the back-ward beds which housed the old long-stay population, most of whom have been resettled into supported accommodation in the community. However, what was not planned for was the "new long-stay" population - those who formerly would have been the candidates for the back wards which no longer exist. The evidence suggests that it is because of the lack of suitable facilities for this group that acute beds are blocked, leading to intolerably high occupancy levels.
There are, of course, two solutions to this problem. We can either go backwards and reopen long-stay beds in asylums or we can go forwards by creating high-support units in the community that offer the chance of long-term rehabilitation. The second option is, of course, more expensive and my fear is that no political party is offering to make available the resources.
Marjorie Wallace's demand for more beds could lead us back down a path that we abandoned over 30 years ago.
TONY GOSS
London SE15
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