Like other professional and lay publications, you drew attention to some adverse features of the Commission for Health Improvement's report on North Birmingham Mental Health trust (news, page 4, 2 August). Having read the report I am more troubled by CHI's methods than by any inference that colleagues in North Birmingham are running a poor show.

The trust provides mental health services for a population of nearly 600,000, 15 per cent of whom will be elderly. CHI chose to exclude from consideration all activities relating to older people.

It must take note of the national service framework for older people - standard one.

It points out its role in this instance was not to monitor progress toward targets in the implementation of the ageist framework for mental illness, so what was it thinking of?

Its interviews with service users were limited to 11 community clients and 13 (presumed current) inpatients.

What sort of balance is that?

The likelihood is that the service is involved with 40 or more 'clients' within the community for every one currently in hospitals. Those in hospital are likely to be finding life particularly tough and disagreeable.

Their comments, realistic or unreasonable, are simply quoted without interpretation as apparently damning facilities, staff and other patients.

This is a serious business.

Making cheap headlines out of casual consideration of people's best efforts is not what we need.

CHI was supposed to be assessing progress toward implementing/interpreting clinical governance. In that it does a fair job reporting the facts, strengths and weaknesses, and the trust has a realistic plan to make improvements. Sound, I would say.

Professor D Jolley Consultant in old-age psychiatry Medical director Wolverhampton Health Care trust