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Wednesday, 13 October, 1999, 17:04 GMT 18:04 UK
510m boost for mental health care
The government plans an overhaul of community care
The government is to invest an extra 510m in mental health services in England, including a revision of the controversial care in the community policy.

Health Secretary Frank Dobson said the extra 510m for NHS mental health services over the next three years would add to the 180m announced last week for social services care of the mentally ill.

He told the House of Commons on Tuesday that mental illness was not "an obscure, minority concern", but affected one in six people at any one time.

Stigmatisation had led to under-resourcing of services for the mentally ill, he said.

Mental Health
Most people were not getting the support they needed, partly because confidence in the system was in crisis.

This was mainly because of the small number of people who were a danger to themselves and others.

"As a totality the system of care in the community has failed because it failed in the most difficult circumstances. You cannot claim success for an arrangement which fails in a crisis," he said.

Mental health law

Others not so seriously ill were not getting the help they needed because of this minority of patients, he said.

Frank Dobson says community care has failed
Mr Dobson called for a change in mental health legislation, saying that existing laws reflected a time when most mentally ill people were in hospital.

He is believed to favour changes which give doctors powers to recall patients who fail to take their medication to hospital.

"We need a law that works in a crisis not one that fails in a crisis," he said.

Specific proposals on changes to the law will be announced next summer.

Mr Dobson also said there was a need for legislation for people who do not respond to treatment.

He and Home Secretary Jack Straw are working on a new form of renewable detention for people with severe personality disorders who are a risk to public.

Crisis teams

The government's Modernising Mental Health Services strategy document also includes a national service framework which will spell out the range of services needed for the mentally ill and how they can best treat people.

This should be ready by next year.

Mr Dobson said there was a pressing need for more mental health beds and 24-hour services to be available in some parts of the country.

Services had to be safe, sound and supportive so the mentally ill could live as independently as possible, he stated.

The new strategy will include:

  • 24-hour crisis teams;
  • More mental health beds;
  • Access for the mentally ill to the NHS Direct helpline;
  • More supported housing and hostels;
  • Home treatment teams;
  • More training for health workers;
  • Improved services for adolescents and young people;
  • Access to new mental health drugs;
  • More day centres for the mentally ill and more outreach teams.

Other NHS reforms coming into force next year will have an influence on mental health policy, said Mr Dobson.

For example, the National Institute for Clinical Excellence will issue guidance on drugs for the mentally as well as physically ill.

Mr Dobson dismissed a call for a combined community care authority, saying there would always be boundaries between health and social services.

The 700m will be broken down with at least 500 million being ear-marked within for targeted change in the way services are delivered.

Around 120 million will be spent on new and effective drug therapies and 70m will go towards training psychiatrists, mental health nurses and other clinical and care staff.

Overwhelming success

Shadow Health Secretary Ann Widdecombe said professionals believed care in the community "has been an overwhelming success and it is only a very small number of inappropriate discharges that have caused quite justifiable concern among the public".

She called for extra funds for new drugs for the mentally ill, which did not have the same side effects as the older treatments.

She said this would make it more likely that patients would take their drugs.

Ann Widdecombe wants the prescription of newer mental health drugs
She also said that the government should have included a mental health bill in the Queen's Speech, setting out the changes in law.

Simon Hughes for the Liberal Democrats welcomed the greater priority being given to the mentally ill, but said the real need was for extra resources.

He said mental health budgets had been cut by one sixth for the past eight years.

He asked if the government would restore the cuts and wanted clarification on how much extra money would be spent per year on mental health.

Meanwhile, the Scottish Office has announced a review of the Mental Health (Scotland) Act 1984.

Health minister Sam Galbraith said it needed to be updated, given changes in mental health treatments and practices in the last 14 years.

The BBC's Fergus Walsh: "The government admits more mental health patients need access to hospital"
Social Affairs Editor Niall Dickson reports on the proposals
The BBC's Fergus Walsh on the new mental health strategy
Chris Prior: Government must show commitment
The BBC's Fergus Walsh on the community care review
Mental health charities and Frank Dobson on the BBC's Today
Ann Widdecombe on community care
Frank Dobson on community care's failings
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