Letters

Published: 23/10/2003, Volume II3, No.5878 Page 20

I have just completed three weeks at the party conferences, where both the Mental Health Alliance and Rethink have tried to keep mental health at the top of the health agenda.

We have been pleasantly surprised: last year the foment over the draft Mental Health Bill was at its peak and we feared that perhaps our moment had passed.

Not a bit of it: Liberal Democrats, Labour and Conservative delegates alike have responded to our events in their hundreds, with a 'full house' of commitments from health spokespeople that mental health is still a high priority.

The next 12 months will probably determine the course of mental healthcare for the next 10 years. It is the key time for delivery on the national service framework, and when more money will be spent on mental health than ever before.

Oh, and there may be a Mental Health Bill, and maybe a Mental Incapacity Bill, too.

Mental health is in the spotlight, and not just because of Frank Bruno. The Commission for Healthcare Improvement's devastating report on conditions in a Manchester ward highlighted a forgotten generation. As worrying was CHI's comment that this was not an isolated case.

So where is the opportunity?

Mental health legislation is a chance for a generation to make a difference: it is up to all of us to get it right. The draft bill was terrible, but at least dialogue is taking place.Hopefully it will lead to an improved bill - but to achieve that it needs to meet four key needs.

First, if people are to be deprived of their liberty, they should gain some therapeutic benefit in exchange. Second, the criteria for compulsion should be narrowed so any future administration cannot use it as cut-price mental healthcare. Third, if people are so ill that they need sectioning, they should be treated in hospital first.

Finally, this is a chance to create real patient-centred care by offering a genuine say in their care through initiatives like advance directives and entitlements to access help.

The real challenge is to put the user at the heart of their own care. It is what the government wants for the whole of the NHS - the litmus test for its success should be in mental health.

Paul Farmer Director of public affairs Rethink severe mental illness