Letters

Linda Seymour's letter (21 October) rightly emphasises the crucial part that well-trained, committed local Mental Health Act managers can play, not only in chairing reviews but in informing and enhancing a trust's understanding of its mental health services.

On the latter point, the scoping study's draft proposals point out the value of managers providing a vehicle for local community involvement in the services. But at the same time the study recommends that Mental Health Act managers no longer possess the power to discharge patients held under sections of the act.

This presumably reflects the apparently significant criticism directed against the managers' review hearings, largely because their role vis-a-vis the review tribunal is not well understood by patients and their relatives.

It would be interesting to know what level of resource or commitment to managers' support and training is being made generally, especially as the scale of their work has increased so significantly.

Without that, and the existence of a strong and effective Mental Health Act administration in a trust, it is not surprising that their decisions are sometimes regarded as capricious and their existence superfluous.

Our experience is that where trusts have invested to train and support their Mental Health Act managers appropriately, there is clear evidence that they can operate in ways that help to improve and develop services to patients.

They also provide an additional, local, low-cost safeguard against inappropriate detention.

Anne Galbraith, Sally Irvine Galbraith and Irvine Associates Northumberland