A Fair Deal for mental health includes local rehabilitation services

Helen Killaspy,Richard Meier

doi:10.1192/pb.bp.109.028530

Abstract

SummaryLack of policy for mental health rehabilitation services has led to disinvestment and expansion of out-of-area placements in in-patient, nursing and residential care settings in the independent sector. Although a minority provide very specialist services that cannot be provided locally, and many provide good-quality care, there are significant concerns about the lack of rehabilitation focus in some of those services, poor links with local care managers and the social dislocation caused by being placed many miles from home. Additionally, out-of-area placements cost more than local rehabilitation services. There is, therefore, a compelling case for all individuals with complex mental health problems to have access to local rehabilitation services in order to expedite their recovery and social inclusion. The Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists has recently published a service template to guide commissioners and service providers in the UK in the kinds of rehabilitation services they need to provide locally.

Highlights

Until recently, the majority of mental health trusts in England provided in-patient rehabilitation services,[1] but in the past 3 years or so this situation has changed dramatically
It is the view of the Faculty of Rehabilitation and Social Psychiatry of the Royal College of Psychiatrists that it has come about as a direct result of the lack of acknowledgement of the need for rehabilitation services in the Department of Health’s National Service Framework for Mental Health.[4]
The investment in community-based services that the National Service Framework brought was very welcome, absence of policy and guidance on rehabilitation services appears to have resulted in the mistaken view that there would no longer be a need for rehabilitation services, as though the people who use them would automatically be absorbed into the new specialist services

Summary

Introduction

The majority of mental health trusts in England provided in-patient rehabilitation services,[1] but in the past 3 years or so this situation has changed dramatically. At the same time there has been a major expansion of in-patient, residential and nursing care in the independent sector.[2,3] This disinvestment in local National Health Service (NHS) rehabilitation services has not come about through government policy.

Results

Conclusion