Charter to tackle fears over care of mentally ill

The Government is to introduce special measures to combat concern about attacks on members of the public by severely disturbed psychiatric patients.

The move, disclosed yesterday by the Secretary of State for Health, Stephen Dorrell, sets tough new standards designed to make the streets safer.

The Mental Health Patient's Charter will ensure:

t Patients get help from nurses or social workers, if they need it, after discharge;

t Home visits will be available within four hours for urgent cases and within two working days for non-urgent cases;

t Patients will not be sent home if it is thought there could be the slightest risk to carers, relatives or the public;

t Tough new time limits for assessing a patient's illness aimed at reducing waiting lists;

t Information on the effects of drugs and other treatments will be available for patients;

t Patients will be allowed to wear their own clothes, have personal possessions and more privacy in hospital while receiving treatment;

t Patients can expect access to a lawyer if necessary and will be able to choose whether they want a man or woman to act as their key worker;

t Explanation of diagnosis will be made available;

t Anyone detained for 28 days or more has the right to apply to a Mental Health Tribunal and get a medical opinion from an independent doctor.

Mr Dorrell hopes the charter consultation, to be officially unveiled in the new year, will go some way to quelling public fears about schizophrenics which began in 1992 when Jonathan Zito was killed by Christopher Clunis at Finsbury Park tube station in north London. There have been a number of other incidents and last August Gerald Malone, the health minister, warned NHS chairmen to improve standards and stop patients falling through the care in the community net.

They were asked to review their services and report back to the Secretary of State. He is due to announce the outcome of the exercise shortly.

Mr Dorrell said: "When there is public comment about the mental health services, people often latch on to the phrase `care in the community' and say this means the Government is not interested in hospital care, which isn't true.

"The phrase has become misleading because it has come to imply that the only type of mental health service we are interested in delivering is one based on community health and that is not the case.

"What we are concerned to do is deliver a spectrum of care, so that someone who is acutely mentally ill has their acute needs met in a hospital; that there is care available in a sheltered setting for those who need it; that there is community care for those who need it; and crisis teams for meeting crisis need.

Mr Dorrell admitted, however, that in parts of the NHS, "we have not succeeded in delivering standards of care that we would all want to see".

Kate Harrison of the mental health charity, Mind, said patients needed more help, not a charter. "Services for people with schizophrenia are not good enough. We need more resources across a spectrum of services from decent housing and occupations to social support. The fear is that a charter is simply more paper that won't provide what's needed."