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Monday, July 27, 1998 Published at 11:27 GMT 12:27 UK


Health

'One in four' need mental health cash

Mental health affects one in four of us, say experts

Mental health campaigners have welcomed reports that the government could be planning to invest up to 1bn in care in the community.

But they are worried that the money will be targeted at the most seriously ill, rather than at all of the estimated one in four of us who will suffer a mental illness.

Ministers are to give guidance on their long-awaited mental health policy to the mental health reference group on Wednesday.

The group of independent policy advisors is meeting to discuss plans to set up national standards for care. The Mental Health Foundation says the present system is a lottery, with some areas have non-existent services while others provide very good care.

A spokesman for the Department of Health said speculation over the weekend about the government's plans had been "well informed". Reports suggest that the government is planning to invest between 500m and 1bn in mental health.

The money is expected to be spent on outreach teams, 24-hour nurse care, more psychiatric beds and building a medium secure unit in every region. Legislation is expected later in the year.

Failings

The government is thought to believe care in the community has failed many patients and, in some high profile cases, endangered the public.


[ image: Community care patient Christopher Clunis killed Jonthan Zito]
Community care patient Christopher Clunis killed Jonthan Zito
Official reports have shown that cases such as that of Christopher Clunis, the care in the community patient who killed Jonathan Zito, are rare. But the media has seized on them to point out failings in the system.

Doctors and experts argue that care in the community has been consistently underfunded. They say closing the big Victorian mental institutions and placing many of their patients in the community is more expensive than keeping them locked up,

The Community Care Act was implemented in 1990 by the Conservatives and followed Sir Roy Griffiths 'Community Care: Agenda for Action' report of 1988.

One in four

The Mental Health Foundation (MHF) and mental health charity SANE welcomed news of the government's plans, but warned that the money should not just be targeted at the most serious cases of mental ill health.

"One in four people suffer from mental health problems every year. The government needs to look at the whole spectrum of services," said a spokeswoman for the MHF.

The Sainsbury Centre for Mental Health said it was in favour of increased investment in community care, but it is worried the money will only be a one-off.

"It will have to be recurring if it is going to work," said senior policy advisor Dr Andrew McCulloch.

He added that it was important to have a balance of services for the mentally ill.

He denied community care had failed. "It has not been implemented properly. It has never been given the chance to work. If we use outreach and proper hostel care and nursing care then we can make the whole system work," he said.

Suffering

Marjorie Wallace, chief executive of SANE, said: community care had been "an experiment which caused immense suffering to many mentally ill people and their families".

She said: "For the majority community care has been a true liberation, but for many thousands of others it has meant fighting for their mental and physical survival alone in squalid flats, beds and breakfasts, hostels or with families who break under the strain."

The Sainsbury Centre believes most people with mental health problems can function in the community if they have proper support and the possibility of day to day care. Only a small number need 24-hour care, it says.

The Centre wants more efforts to recruit staff. It says training needs to be modernised because staff are being trained in the same way as they were around 30 years ago, although the system has changed. Many staff are overloaded and demoralised.

SANE also wants more investment in training, as well as the establishment of centres for excellence in mental health care and more psychiatric beds. It says current occupancy rates of psychiatric beds run at 100-140%.



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