Time to define the boundaries of psychiatric care

In Modernising Mental Health Services, the new national mental health strategy for England announced in December, 1 2 the government lays out detailed plans for reforming general psychiatric services, and places them in the context of its wider NHS reforms. The document asserts that “community care has failed” and blames underfunding, inadequate services, overburdening of families, problems in recruiting and retaining staff, and an outdated legal framework. It then describes a strategy for providing a service “in which patients, carers and the public are safe and where security and support is provided to all.” This strategy has two key elements: increased investment and increased control (over patients and clinicians).

The increased investment consists of =A3700m spread over three years. These extra funds will provide more beds (in hostels and secure units); outreach teams and 24 hour access; new treatments, including atypical neuroleptics; and staff training. Increased control of patients will be achieved by “modernising” mental …