letters

Published: 20/11/2003, Volume II3, No. 5882 Page 22 23

Health minister Rosie Winterton states in her HSJ interview (30 October, page 24) that there is now a consensus in favour of updating the Mental Health Act.

While it is true the 1983 act is now incompatible with human rights legislation, few people who work in or use mental health services would agree that the government's current proposed alternative is at all preferable.

The Mental Health Alliance is keen to see better mental health legislation on the statute book.

We believe that a Mental Health Act fit for the 21st century can be created if the government works with our members and listens to the thousands of people across the country who responded to the draft bill last year.

We hope the government will take an open approach to the issue. The new legislation must respect the civil liberties of people with mental health problems and help them secure access to appropriate care and treatment.

Simply making minor amendments to the draft bill will not achieve that goal.

Paul Farmer Chair Mental Health Alliance

As a former mental health and learning disability trust director, I agree with St Andrew's Group of Hospitals chief executive Sir John Brigstocke's view (feedback, 16 October, page 26) that involvement of the independent sector to support capital investment in mental health may be a useful way to address some of the issues superbly identified in HSJ's Fit for Purpose campaign.

However, I believe that more sustainable progress can be made, outside of any formal concordat, by the NHS and statutory services working more closely together to deliver integrated solutions locally to the many challenges facing a modern mental health service.

An approach that sees the NHS and independent sector delivering innovative services jointly will certainly improve premises, but will also ensure issues such as staff recruitment and training can be tackled together. I would suggest this approach, based on trust and the development of strong local relationships, can be delivered without a formal concordat.

I urge NHS managers and clinicians to forget any apprehensions they may have about working with the independent sector. Instead, consider creatively the role it can play to support delivery of improved mental health services.

James Allen Development director Care UK

The development of specialist early intervention teams within mental healthcare is a key element of the NHS plan.

Bedfordshire and Luton Community trust has now become the first mental health trust to secure government funding to allow an early intervention service for people with psychosis to be rolled out countywide.

Funding for the project, which the trust is undertaking in partnership with local authorities and local primary care trusts, is in the region of£1m over three years.

We have one team in place and fully operational. Known as Leap (Luton early action in psychosis), it includes nine core managers, a psychologist, an associate specialist and a consultant psychiatrist. A social worker will join shortly. Our second team - to be based in Bedford - is now being recruited.

The evidence gathered so far is positive. This is particularly important in a town like Luton, which has high rates of depression and correspondingly high morbidity rates for psychosis.

The town's multi-ethnic population is a contributing factor, as the interplay between ethnicity and mental health is of great importance. The trust is to explore this at a conference in the near future.

Dr Mark Agius Associate specialist Early intervention team Bedfordshire and Luton Community trust