Government ditches care in the community

THE GOVERNMENT reverses its policy of care in the community tomorrow, taking thousands of mentally ill people off the streets and forcing them to comply with treatment.

Frank Dobson, the Health Secretary, will publish the long-awaited White Paper on mental health designed to improve supervision of those with mental health problems and make more 24-hour care available.

It is believed he will announce funding of pounds 185m from social services and pounds 470m from the health service to cover the plans. Key reforms include more "acute" and "secure" beds in psychiatric hospitals, more trained staff and the introduction of a 24-hour helpline.

One of the more controversial plans gives doctors the power to force patients who refuse to comply with treatment to be re-admitted to hospital.

The Government also wants to change legislation so that it covers those with untreatable personality disorders. The Mental Health Act only covers those with "treatable" conditions. This would cover people like Michael Stone, convicted of the murders of Lin and Megan Russell, who suffered from a psychopathic disorder.

In July when Mr Dobson announced reform of the Act, he promised a "root and branch" review because the Act was "based on the needs and therapies of a bygone age". While pledging this did not mean a return to locking people up in long-stay institutions, he added that too many people had been left "wandering the streets".

The proposals signal an end to the care in the community policy, which has been criticisedafter a succession of high-profile inquiries, such as into the killing of Jonathan Zito by Christopher Clunis, a paranoid schizophrenic, at a London Underground station in 1992.

Since 1980, 50,000 psychiatric beds have been closed, leaving many to live in hostels or flats with little back-up support or care. The mental health charity Sane estimates a homicide is committed by a mentally ill person every week. About 1,000 mentally ill people commit suicides every year.

Marjorie Wallace, the chief executive of Sane, said yesterday health officials had been left with "blood on their hands" by continuing with the policy of community care and closing psychiatric hospitals. "Now we will have a chance to reverse this policy which has led to hundreds of unnecessary deaths and incalculable suffering for patients, their families and the public. Accepting that so many people have been failed is a major victory," Ms Wallace said.

But a spokeswoman for the charity Mind said that while itwelcomed more 24-hour care, it disputed that care in the community had failed. "Community care has been woefully underfunded and there have been some dramatic failings but there have been quality and properly funded services and they have worked," she said. The charity also disagreed with compulsory treatment. "It is people at ground level who will have to deal with this - psychiatric nurses and social workers and they have already said it won't work."

The National Schizophrenia Fellowship said the money earmarked for reforms was "only a third" of what was needed.

A spokesman for the Department of Health said that he could not comment until the paper was published.