After a bad start on mental health policy, ministers and their critics are slowly moving towards an accommodation which could allow real progress to be made on compulsory treatment in the community and the much- needed reform of mental health legislation (see news, pages 6-7).
Proposals to give service users new rights to assessment and an 'adequate' level of services represent a step forward both from existing practice and from government rhetoric which has done much to undermine the confidence of service users and mental health professionals alike over the past two years.
The proposed introduction of an independent body to approve compulsory treatment will also go some way to allaying the fears of those who might otherwise shy away from mental health services altogether - as the National Schizophrenia Fellowship's survey appears to confirm.
Professor Genevra Richardson and her team have done sterling work - and have delivered their proposals far faster than many anticipated. At the present rate of progress, there should be no reason why legislation is not possible in this parliament.
But problems remain. Mind, which argues for a stronger human rights element to underpin a new act, still 'regrets' the proposals, and rightly points out the absence of service users on the review committee. It has a point: there is no shortage of articulate and able mental health users, and no excuse to exclude them.
Furthermore, the NSF survey offers little cause for optimism since, as Paul Farmer suggests, many of those who have gone through hospital psychiatric treatment are prepared to accept compulsion in the community on the grounds that it cannot be worse. This is a counsel of despair indeed - but, as our report on the drawn-out saga of High Royds Hospital and St James' Hospital's Roundhay wing in Leeds must make apparent, it is a despair rooted all too deeply in the reality of some hospital-based mental health services (see news focus, pages 10-11).
There is clearly much to be done - possibly in toughening up the human rights elements in Dr Richardson's proposals, but certainly in defining what an 'adequate' level of services might be, both in hospital and in the community. It is not just community care that has failed.
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