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Thursday, September 30, 1999 Published at 12:47 GMT 13:47 UK


Mental health blueprint: The reaction

Campaigners want more money for the mentally ill

Campaigners have welcomed the first national care standards for the mentally ill, but say they need to be backed by substantially more cash.

The National Service Framework for mental health sets out the kind of treatment adults in England should expect from health and social services.

Campaigners say the framework is the first step to tackling care by postcode, but they believe real change will only be achieved with extra funding.

The government has pledged £700m over three years to support its "Third Way" reforms for mental health, but many believe this is not enough for a service which they say has suffered yeras of neglect.

A spokesman for the National Schizophrenia Fellowship (NSF) said: "We are worried there will not be the resources to implement the framework.

"Some health authorities are cutting their mental health budgets and the mentally ill are still being turned away because of a shortage of beds and staff."

Sane also called for more resources to back the new standards as well as to ensure the mentally ill had access to the best available drugs and other therapies.

Its chief executive Marjorie Wallace said: "If the extra resources do not provide the backstop of a sufficient number of nursed beds, hospitals wards that are asylums rather than bedlam, staff trained in risk assessment and management, and increased accountability of services, these proposals could prove as ineffective as all previous reforms."

Care plans

However, campaigners welcomed the principle of the framework, particularly proposals to provide 24-hour care, a written care plan and a bed for everyone assessed to need one.

A recent NSF survey of 450 people with a mental illness shows 65% are not given a copy of their care plan, even though local authorities have a duty to provide it.

"If they have a care plan which they understand, they can start taking some control of issues such as the drugs they are given, housing and social care," said an NSF spokesman.

Charity Mind supported the inclusion of written care plans in the framework, but said urgent action to ensure patients had a greater role in devising them.

It also wants them to be more flexible, suggesting more than one type of treatment.

However, it welcomed the framework's emphasis on social exclusion, improved assessed for ethnic minorities and mental health promotion.

Campaigners also gave a broad welcome for the framework's recognition of the role of carers.

Currently relatives and partners who care for the mentally ill only have the right to have their needs assessed by local authorities.

An assessment might identify that they need regular short-term breaks from their caring responsibilities.

But local authorities have not had to provide these services.

The framework says carers should get their own written care plan. A Department of Health spokeswoman added that the expectation behind this was that any need identified would be met, but this could not be guaranteed.

Services for the 21st century

The Mental Health Foundation said the framework's success would be judged on whether it reduced the number of people compulsorily committed to hospital as a result of better early intervention, on the experiences of patients, on the morale of professionals and on public understanding of mental health issues.

June McKerrow, the foundation's director, said: "We need services appropriate for the twenty first century, not services that write people off, refuse to take account of their experiences, or increasingly subject them to inappropriate compulsory treatment."

But health charity the King's Fund welcomed the framework.

Chief executive Rabbi Julia Neuberger said: "It is heartening to see that it includes action to improve primary care, support to carers and recognition of black people's poor experiences of mental health care.

"The challenge now is to turn these good ideas into practice."

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