I applaud Jay Watts for illuminating the emotional, therapeutic and practical shortfalls in England’s mental healthcare delivery (England’s mental healthcare lacks money, yes – but it also lacks compassion, 10 November). Having worked as a therapist in a community mental health unit attached to a small general hospital in west London during the late 1980s, the die was cast for floundering patterns to eventually flourish apace.
The then Thatcher government was ruthlessly bent on urgently closing residential units across the nation, under the fallacious guise of promising comprehensive community support that never effectively materialised. It was simply a funding cut measure, totally oblivious to the obvious, ie that viable community care is even more expensive than residential.
Thus the on-street debilitation continued apace, cultivating a protracted problem that has come home to roost. The case for wholesome, vibrant community care is both patent and blatant, and would go a long way to reduce the many drawbacks inherent in delivery of residential care, as Watts highlights. Sadly, appropriate funding for this is still not forthcoming. More’s the pity.
Lismore, County Waterford, Ireland
I think it’s important to highlight that in the 1980s all the in-house psychiatric hospitals were reduced, due to financial constraints. There was a promise of more community-based care to supplement the lack of in-house care. Since then it could be argued there has been a direct link between homelessness and the reduction of beds. An understanding of the context and history of this problem is important.