'Health minister Paul Boateng faces a dilemma in attempting to balance the first duty of mental health services to their users and the public protection which any government must ensure'

Ministers find themselves facing two ways on mental health policy. At one level there is little to fault in health minister Paul Boateng's day-to-day policy decisions: he announces a poster campaign to reduce the stigma of mental illness here, a little more money for family support there, and so it goes on.

Yet at the same time, broad hints are dropped about the need to make the 'public protection' role of mental health services their top priority, and even Labour's natural constituents in the voluntary sector are becoming concerned at the draconian policy ideas known to be floating around Whitehall.

Setting up the Independent Reference Group last year was clearly one of the government's better moves on mental health. It has, by all accounts, done sterling work on the detail of hospital closures and service reprovision, and has provided a forum in which groups with widely differing views can work.

But excluding the IRG from the real policy development work while wasting the time of its member organisations in pointless 'summits' of the sort they attended last week risks causing a rift between the government and the important voluntary mental health sector.

The existence of a draft policy document on mental health has been common knowledge for months. After last week's Journal , its contents are widely known. Yet officially there is no new policy. It is not just the voluntary sector which finds this continuing stance patronising and infuriating.

Perhaps we should feel sorry for Mr Boateng. The general belief is that he is under pressure from Downing Street's policy unit to end high-profile community care 'failures', while knowing that the community staff who would have to deliver the policy generally do not accept it is desirable or practical to enforce measures such as compulsory treatment in the community or the virtual house-arrest of mentally ill people. But politics is about difficult decisions.

His best hope now is to admit that he faces a dilemma in attempting to balance the obvious first duty of mental health services to their users and the public protection which any government must ensure.

Ideally, that would involve tearing up the policy document in its present form - a document which anyway makes too many concessions to the Downing Street news management agenda - and enabling the IRG to make a real and substantial contribution to its replacement.