Louis Appleby was appointed national director for mental health in April last year, with a brief to 'spearhead the government's drive to modernise and reform mental health services'.

Professor of psychiatry at Manchester University, where he leads research as director of the National Confidential Inquiry into Suicides and Homicides by People with Mental Illness, Professor Appleby has played a leading role in work on the white paper.

The 45-year-old says his own clinical experience has impressed on him the need for such reform.

'You discharge people and you know, because you have already admitted them so many times over the years, that they will be back because the recovery will not be sustained if they come off their medication. . . but often there is nothing you can do until they reach crisis point.

'That is very distressing for them, and especially distressing for families who know they have a timebomb to face.'

He also insists that the white paper's enthusiasm for advocacy is not just a sop to the charities. 'Speaking personally, I am very keen on this.'