Tighter controls over care in the community for mentally ill

THE GOVERNMENT is about to change the law to ensure closer supervision and control of mentally ill patients released from hospital into the community after incidents in which former psychiatric patients have harmed themselves or others.

The Department of Health confirmed last night that changes to the 1983 Mental Health Act will be announced next week.

Reports claimed there would be three key changes which would involve tighter restrictions on the discharge of patients from hospital; closer supervision and tracking of individuals after discharge; and the introduction of supervised discharge orders so patients failing to take medication can be forcibly readmitted to hospital.

Strengthening the role played by hospitals in the care of severely mentally ill patients would be a significant shift in the Government's Care in the Community policy.

Saying BBC reports were 'speculative', Virginia Bottomley, Secretary of State for Health, added: 'We currently spend pounds 2bn a year on services for the mentally ill. In line with long- established and widely supported principles of care in the community, an increasing proportion of that money is spent on community-based services. There are, for example, over three times as many community psychiatric nurses today as 10 years ago.

'Despite this increase in resources a small number of cases slip through the net. The Government's review of the implementation of the Mental Health Act has analysed thoroughly the reasons for this. It is on that basis that the Government will shortly put forward proposals designed to improve the current arrangements and ensure greater protection for both mentally ill people themselves and for the public.'

The changes come after the cases of Ben Silcock, a schizophrenic mauled when he climbed into the lions' den at London Zoo, and, more recently, Christopher Clunis, a paranoid schizophrenic who, after drifting in and out of hospital for six years, killed Jonathan Zito on a London railway platform last December by stabbing him in the eye, three months after being discharged from Guy's Hospital.

The victim's widow, Jayne Zito, made an impassioned appeal to Mrs Bottomley to hold a public inquiry into why Mr Clunis was not receiving the care and supervision he needed.

Last night Mrs Zito said: 'At least the Government is acknowledging the crisis of the situation. I think it is necessary to make tighter restrictions on liberty in cases like Mr Clunis but I just hope they make other facilities, such as housing care and support staff available as well.'

Leaks of the government proposals came as Judge Stephen Tumim, the chief inspector of prisons, added his weight to demands for a review of procedures governing the detention of the mentally ill.

He said a gravely ill homeless schizophrenic needing hospital care had been wrongly held in Brixton prison for three months while psychiatrists debated whether department guidelines enabled him to be transferred to a secure hospital. In the past year there had been 14 similar cases.

Brixton praised, page 4