Mental health takes wrong approach

The improvements to community mental health services found by the Healthcare Commission are to be commended, but not without a word of caution regarding the 350,000 service users who are shortly to be removed from the care programme approach in the coming months, as they receive only "standard" rather than "enhanced" care.

The care programme approach, while far from perfectly implemented, has been one of the main drivers of service improvement over the last two decades, by providing a national framework and standards for community mental healthcare.

While the aspiration behind the changes of improving services for those with the most complex needs is admirable, we do have concerns that this might be achieved at the expense of the three quarters of clients who will no longer be covered by the programme. Many of these service users have chronic and serious mental health problems. There is a real risk that they will be exposed to a postcode lottery of services, as cash-strapped local trusts are no longer obliged to meet formal care programme approach standards.

Simon Lawton-Smith, head of policy, Mental Health Foundation