Dear Sirs,

In the discussion about the cost of Community Care 1,2 it noteworthy that there is a very strong inverse relationship between psychiatric bed availability and the number of prisoners across countries 3, as it is in the UK.4

Many of the destitute homeless have serious psychiatric illness, with a high proportion of schizophrenia, and often suffer from partially treated Tb.5

Having closed the long stay beds one wonders if the attrition of acute beds is appropriate.

As a second opinion approved psychiatrist, this author was told not to proceed with an evaluation for possible compulsory admission (criteria danger to self or others) because no bed was available!

Prof. Malcolm Weller, retired NHS Consultant.
Previous Chairman of CONCERN

1.Hawkes N. The NHS must change or die. BMJ 2012:e4478 (4 July)

2. Tealle K BMJ Is community care any cheaper? 2012; 345 :e4976
3. Penrose LS. Mental disease and crime: outline of a comparative study of European statistics. Br Med Psvchol 1939;18:1-15.

4. Mentally abnormal prisoners on remand. Weller MP, Weller BG, Badenoch D … - BMJ: 1988.

5. Weller, M. (1989) Mental illness who cares? Nature, 339, 249-252.

Competing interests: None declared