The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness should continue.

It provides an unmatched analysis of the factors involved in the unacceptable numbers of these suicides and homicides and points the way to preventing future tragedies. But we are concerned there still appears to be no intention to monitor the implementation of inquiry recommendations.

We agree with Louis Appleby's emphasis on clinical practice and training in improving safety in mental health services. SANE has identified a disturbing failure of risk assessment in two thirds of the 69 independent homicide reports we analysed - a figure echoed in our experience in cases of suicide. Without rigorous follow-up to the findings of these national inquiries, there will be more unnecessary loss of life.

Marjorie Wallace, chief executive, SANE