A major review of mental health services is being considered by the government to address the failures of care in the community, according to a draft policy document seen by the BBC.

It says public safety should be a priority, following violent attacks by patients being treated in the community.

Schizophrenic Christopher Clunis claimed he killed because he was given inadequate care

The document also says there has been a shortfall of £500 million in the funding of services for mental patients. It suggests an extra £50 million should be spent each year for the next decade.

Care in the community was the policy introduced in 1990 after the release of many patients as residential mental hospitals were closed. It was supposed to provide the humane alternative to conditions in rundown Victorian-era institutions.

The BBC's Social Affairs Editor Niall Dickson says people have no confidence in care in the community (1'-13")

However, the document says care in the community has become a discredited policy in the public's mind. It says that all too often people equate it with leaving vulnerable people to struggle unsupported and uncared for.

Critics often cite a series of violent attacks and murders carried out by released mental health patients who have received inadequate care in the community.

One of the most publicised was the murder of Jonathan Zito, who was stabbed to death by schizophrenic Christopher Clunis in 1992. His widow Jayne set up a charity, the Zito Trust, to campaign for better care of people like her husband's killer.

Hugh Coll: left "a complte nervouse wreck" after he was stabbed

Hugh Coll, a survivor of another attack by a schizophrenic, was repeatedly stabbed by a stranger at a bus stop last year.

Mr Coll said the experience had left him "a complete nervous wreck" and anxious about leaving home. "A lot of people say 'you need to get out more.' But they don't understand," he said.

Cases such as these led Health Secretary Frank Dobson last month to make a speech describing care in the community as a failure. He promised major policy changes.

The Department of Health says the document seen by the BBC is a draft and had not been approved by ministers. It added that a policy review was underway and that no more hospitals would be closed until there are creditable care arrangements in place in the community.
 

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