Your news story 'Bed-blocking exacerbated by lack of secure 'stepdown' facilities' (page 7, 1 October) has wide ramifications for service delivery under the government's national service framework for mental health.
Research by the National Schizophrenia Fellowship as far back as 1991 showed a crisis in the provision of acute beds.
The new research from Mental Health Strategies supports anecdotal evidence collected by our advice service that the position is even worse today. No doubt the national beds inquiry ordered by health secretary Frank Dobson will paint a similar picture.
NSF supported the private member's bill promoted by Julian Lewis MP earlier this year that would have made it the duty of health authorities to draw up strategic plans to ensure enough appropriate beds in the community and in hospitals were available for people with a severe mental illness.
The bill was blocked by the government.
The problem is much wider than bed availability in hospitals. The present review of the 1983 Mental Health Act has terms of reference promoting some form of compulsory treatment in the community, what the government calls a 'safety-plus' approach. If so-called compulsory community treatment orders were introduced, they would simply present people with a severe mental illness with an extra layer of policing if the underlying question of resources is not addressed.
In Australia community treatment orders exist within a wider, better resourced framework of comprehensive services, including 'step-down' facilities such as 24-hour nursed care and crisis beds.
Introducing community treatment orders as a panacea for media-driven public fears is not the answer. We need the kind of holistic approach the national service framework could offer if it were fully resourced.
Cliff Prior Chief executive NSF Kingston upon Thames