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This factsheet is intended for students and others who are interested in the history of community care. Information on history before the seventeenth century can be found in the factsheet Notes on the history of mental health care. Copyright note for Mind factsheets: You are welcome to print and photocopy this page of Mind's website. Organisations are free to distribute copies to service users and colleagues, but must ensure they always use the latest version, as available on the website, at the time of distribution. 1601 The Poor Law was introduced and clearly defined the responsibility of every parish to support those who were incapable of looking after themselves. This responsibility was limited to people born or defined as being 'settled' in a parish. Other people who did not fit these categories could be expelled from the parish. 1808 The County Asylums Act 1808 gave permissive powers to the Justices of each county to build asylums, paid for by local rates, to replace the few psychiatric annexes to voluntary general hospitals. However, this development was very slow. 1834 The Poor Law Amendment Act 1834 required relief to be provided within institutions only. This led to the construction of a huge network of workhouses. 1845 The Lunacy Act 1845 required counties to provide asylums. The majority of Britain's psychiatric hospitals were built during the next 25 years. The growth of asylums was fuelled by funding arrangements that encouraged local parishes to move the parish poor into asylums, as these were funded by the county councils rather than the parishes. 1860s The workhouses were obliged to build 'infirmary' annexes - the first general hospitals (to be set up as a legal requirement). 1863 The Mental After-Care Association (MACA, later renamed Together) was established: a voluntary organisation providing short-stay residential homes for discharged psychiatric patients in the Greater London area. 1875 The Government began to pay a subsidy to Poor Law authorities of up to 25 per cent of the cost of supporting 'pauper lunatics' in asylums. This was the first central government financing of any health or social care service. 1880 The second wave of asylum building began. 1890 The Lunacy Act 1890 brought in laws regulating asylums and compulsory care.
1891 The Lunacy Act 1891 imposed rigid procedures and criteria so that only people with the most severe mental illnesses were likely to be admitted to hospitals. 1909 A report of the Poor Law Commission was published, based around two central principles:
in terms of health care, that prevention is cheaper and more effective than cure in terms of social care, that charitable activity has its proper place in supporting a public service.
The report also suggested that the Poor Law should be replaced by specialised social services dealing with separate categories of people. The subsequent development of the National Health Service (NHS) in 1948 and local authority social services can be seen in terms of these principles. 1923 The Maudsley Hospital was opened by London County Council. It was the first psychiatric hospital to operate outside the restrictions of the Lunacy Act. 1923 The Tavistock Clinic was founded as a centre for psychotherapeutic training and treatment. 1926 The Report of the Royal Commission on lunacy and mental disorder suggested that outpatient clinics should be opened and aftercare services developed, as well as voluntary admission to psychiatric hospital. The emphasis was changed from detention to prevention and treatment. 1930 The Poor Law was reformed and terms such as 'pauper lunatic' were abolished. Outpatient work by the medical staff of public mental hospitals was permitted. Legislation brought the workhouse infirmaries under the control of local authorities. More of these progressed towards becoming general hospitals. Many had observation wards where patients were admitted under the Lunacy Act, while others had long-stay wards for non-acute psychiatric patients. 1930 The Mental Treatment Act 1930 allowed for voluntary admission to psychiatric hospitals. 1930s The 1930s saw the introduction of physical treatments such as electroconvulsive therapy (ECT), lobotomy and insulin coma treatment, allowing the early discharge of some people back to the community. By 1936, 143 outpatient clinics were operating, some of which had social workers attached to them. (Insulin coma therapy was abandoned in the 1960s, having been conclusively shown to be ineffective.) 1939 The Feversham Committee on voluntary mental health associations (1936-39) recommended the amalgamation of three major mental health organisations: the Central Association for Mental Welfare, the Child Guidance Council and the National Council for Mental Hygiene. Although the formal merger did not occur until the end of World War II, the associations worked together during the war through the Provisional Council for Mental Health. The Government asked the Council to provide a national aftercare service for people discharged from military service on psychiatric grounds.
set up day centres and hostels and provided training services for social workers and residential care staff. providing greater flexibility in psychiatric services and reducing the use of hospital beds. so that beds in regional mental hospitals were no longer needed. for example. academic and Government advisor. 1957 The Report of the 1954-57 Royal Commission on the law relating to mental illness and mental deficiency (the Percy Report) was published. The Commission recommended that.net/ 1948 The National Assistance Act 1948 stated that. A full history of the NHS can be found on Geoffrey Rivett's website. following the introduction of social methods of rehabilitation and resettlement in the community. The report marked a turning point in official policy from hospital-based to community-based systems of care. this report shaped government social policy for the rest of the century. 1950s Day hospitals began to be established. Friern Barnet hospital was built in 1851 to accommodate 1000 patients but by 1950 it accommodated over 2000. by reason of age. the availability of welfare benefits and the introduction of antipsychotic medication.nhshistory. The introduction of neuroleptic drugs helped to shorten the time that newly admitted patients spent in hospitals and encouraged the discharge of many into the community. 1946 The National Association for Mental Health (NAMH. supporting inpatients who had been discharged and helping them to find jobs and accommodation. 1955 From 1955 onwards. the journalist. which later became Mind) was formed by the amalgamation of the three major mental health organisations (see 1939). the resident population of psychiatric hospital beds reached a peak of 152. 'the law should be altered so that whenever possible suitable care may be provided for mentally disordered patients with no more restriction of liberty or legal formality than is applied to people who need care because of other types of illness. 1948 The National Health Service was established. psychiatric inpatient numbers began to decrease slowly. Croydon. William Beveridge. 'it shall be the duty of every local authority to provide residential accommodation for persons who. This.' The Commission also recommended that. Their duties included visiting outpatients.1942 In December.000. NAMH lobbied for better services for people with mental health problems. together with the recent introduction of welfare benefits. illness. and being available to give advice at outpatient clinics and therapeutic social clubs. Hostels and therapeutic social clubs were set up to provide support for discharged patients. 1954 The first outpatient nurses were appointed at Warlingham Park Hospital. encouraged the beginning of the move from institutional to community-based care. http://www.better known as the Beveridge Report after its author. this provided a model for future service changes. are in need of care and attention which is not otherwise available to them'. Patients may receive medical . disability or social difficulty. Many of the hospitals were extremely overcrowded. disability or any other circumstances. the British Government published the watershed report on social insurance and allied services . 'the majority of mentally ill patients do not need to be admitted to hospital as inpatients. Some new district psychiatric services were developed in general hospitals. 1954 After rising steadily throughout the first half of the century.
stated that progress in modernising the organisation of mental health services was lagging behind progress in applying modern methods of treatment. but many local services were not yet in place. Locked doors were beginning to disappear as a feature of psychiatric wards. 1961 Enoch Powell. 1972 NAMH changed its name to Mind. Following the recommendations of the Percy Report. 1970s Debate focused on reviewing the Mental Health Act 1959. 1970 The Chronically Sick and Disabled Person's Act 1970 required local authorities to determine the needs of people in their local populations and to provide certain services for them. Social security benefits for board and lodging charges became available to individual claimants. made his famous 'Water Tower' speech to the annual conference of NAMH. Limited progress was made towards the aims of the 1975 White Paper (see below). allowing most psychiatric admissions to occur voluntarily. At the same time. Inpatient numbers continued to fall. then Health Minister. The Government introduced a small joint finance fund to encourage the transfer of services from the NHS to local authorities to foster community-based developments. Powell's plan was for 'nothing less than the elimination of by far the greater part of this country's mental hospitals as they stand today'. The Mind office in Wales was opened. procedures and safeguards around compulsory detention and treatment were tightened. 1970 The Local Authority Social Services Act 1970 created social services departments as we now know them. They also had a duty to publicise the availability of these services. 1968 The Health Minister.) . 1962 The Hospital plan for England and Wales stated that large psychiatric hospitals should close and that local authorities should develop community services. all personal social services were to be brought together in one department. (It was renamed Mind Cymru in 1997. 1960s It became commonplace for psychiatric nurses to work with patients outside of hospitals. A new group of 'long-stay' patients began to accumulate in the hospitals. Robinson proposed the 'Worcester development project' to demonstrate how the problems of transition from the old psychiatric hospitals to modern communitybased mental health services could be identified and solved in a cooperative exercise between local health authorities and local authorities. With effect from 1972. Kenneth Robinson.' 1959 The Mental Health Act 1959 reinforced the Mental Treatment Act 1930. Many long-stay patients who were formerly a charge on the NHS were discharged to the community.treatment from general practitioners or as hospital outpatients and other care from community health and welfare services. He envisaged that psychiatric hospitals would be phased out and replaced by care provided in the community. The era of community care had begun and has remained official policy ever since. where they were to become a charge on local authorities but the charge was moved to the Department of Social Services. the procedure for deciding whether a person should be compulsorily detained in hospital changed from a judicial to an administrative process.
local authorities and the voluntary sector. this White Paper came at a time of recession and pessimism about public services. This was essentially a government prospectus for the future planning of social work. . There were calls for government action and increased spending. Leading businessman Sir Roy Griffiths was given responsibility for reporting on this (see 1988). Section 28a of the Act gave health authorities the power to transfer money to support local authority services. The proposition that community care should be cost neutral is untenable. particularly in relation to people with mental health problems. local community. it had little impact on the haphazard dissolution of the hospitals and the almost total failure of statutory authorities to provide adequate community-based care. However. It set out a blueprint for an integrated local approach to mental health care involving the NHS.. Section 117 of the Act imposed a duty on district health authorities and social services departments (in cooperation with voluntary agencies) to provide after-care services for people discharged from hospital. Consultation and Representation) Act 1986 was introduced to strengthen the legislation laid down in the Chronically Sick and Disabled Persons Act 1970..' 1986 Even though the psychiatric hospital population had halved between the mid-1950s and the mid-1980s. 1983 The Mental Health Act 1983 provided safeguards for people in hospital. The White Paper set out the facilities that were required and set numerical targets for achieving better and more appropriate services. it was 1986 before the first psychiatric hospital was fully closed down. Many of the large old hospitals closed in the late 1980s and early 1990s. 1986 The Disabled Persons (Services. but in terms of their relationships with family. Section 28a was introduced primarily to assist with the re-provision of mental health services from NHS long-stay psychiatric hospitals to newly developed services in the community. Better services for the mentally ill. It recommended that people in need should no longer be seen as isolated individuals. local authorities had not been allocated the resources necessary to provide alternative forms of care. 1977 The NHS Act 1977 was introduced. 1981 The Department of Health published a consultation document entitled Care in the community. looked at developments since the 1962 Hospital plan. etc. Any fool can close a long-stay hospital: it takes more time and trouble to do it properly and compassionately. 1986 The report of the Audit Commission for Local Authorities in England and Wales Making a reality of community care pointed out that despite the reduction in the number of hospital beds. 'A decent community-based service for mentally ill or mentally handicapped people cannot be provided at the same overall cost as present services. friends. The report stated that social services should be organised on a local patch basis. 1985 The Social Services Select Committee report Community care with special reference to adult mentally ill and mentally handicapped people stated that hospital closures had outrun community-care provisions. Section 4 of the new Act gave local authorities the duty to assess people for services if asked to do so by the individual or their representative or carer. In the Committee's own words.1975 The White Paper. 1982 The Barclay Report was published.
) 1988 The Griffiths report was published. to local authorities. The CPA relied on liaison between health and social care agencies to ensure that people with mental health problems received appropriate levels of support in the community. for the registration and inspection of homes and other community services either purchased or provided by them. The report recommended giving 'earmarked' grants. It was designed to encourage authorities to plan together so that a broad spectrum of services would be developed. and to have a direct route into policy development. day care and respite services to enable people to live as independently as possible in their own homes. 1990 The NHS and Community Care Act 1990 made all the legal changes necessary for the implementation of the Caring for people White Paper. in collaboration with health-service and independent-sector agencies. Local authorities. It set out a framework for changes to community care. giving guidance on how they should fulfil their duties as laid out in the NHS and Community Care Act 1990. These changes enabled some of the large older institutions to be closed. . now became responsible for assessing need. This would mark the beginning of the purchaser/provider split whereby social services departments were encouraged to purchase services provided by the independent sector. its recommendations including the appointment of a Minister of State for Community Care and the transfer of all community care to local authorities. It also recommended that local authorities be allowed to purchase services from other agencies. A wealth of voluntary sector facilities has since been developed. Other objectives included quality initiatives around assessment of need and case management.1987 The Mind Consumer Network was set up to inform and advise on the experiences. including North Wales. partly funded by central government. 1991 Local authorities were made responsible. 1991 The 'mental health specific grant' was introduced for mental health services in the community. self-help groups and employment training. under the NHS and Community Care Act 1990. The next decade saw a dramatic increase in the number of voluntary and private sector service providers. Mid-Wales and Pen-y-fal hospitals. 1989 The White Paper Caring for people was published in response to the Griffiths report. The CPA set out a practice framework for health authorities in England. Parc. designing care packages and ensuring their delivery. including drop-in facilities. 1991 The 'care programme approach' (CPA) was introduced in an attempt to improve and standardise the delivery of community care services. 1992 Report of the All Wales Advisory Group on Forensic Psychiatry. views and opinions of service users. 1989 The launch of the 1989 All Wales mental illness strategy (Welsh Office 1989) provided an impetus to develop mental health services in Wales. This grant could only be spent with the joint agreement of local health authorities and social services departments. The report promoted the development of domiciliary. which included a new funding structure for social care. Community-orientated and locally based services were developed to include the establishment of multidisciplinary community mental health teams (CMHTs) throughout Wales. (The following year it was renamed Mind Link. Carers' needs were addressed by prioritising practical support initiatives for them.
education or training. The protocol complemented the All Wales mental illness strategy (1989) and identified a range of health-gain targets for people with mental health problems. some service users could be required to live at a specified address and to attend certain places for treatment. making it illegal to discriminate against people on the grounds of physical disability. which addressed: . 1993 The Secretary of State for Health issued Guidance on the introduction of supervision registers.1992 Under the NHS and Community Care Act 1990. 1995 The Disability Discrimination Act 1995 was passed. The application of the Act to people with mental health problems was initially quite restricted. and provide local authorities with criteria against which they could measure and improve their services. embracing the principles of the CPA. voluntary organisations. The framework stated that local authorities should consult users and carers. 1993 Local authorities were given the responsibility for making community care assessments. No requirement was placed on health authorities and trusts in Wales to establish and maintain supervision registers. Under this bill. but they could not force the person to have treatment against his or her will. The forum was addressed mainly to the board members of health authorities and family health service authorities to assist them to develop their local strategies for health. 1996 The Welsh Office published Guidance on the care of people in the community with a mental illness.Welsh Office NHS directorate planning forum was published. People considered to be 'at risk of harming themselves or other people' could be placed on a supervision register. occupation. The 'supervisor' could also authorise another person to use the power to 'take and convey' the service user. The aftercare arrangements for each individual would be kept under review. local authorities were expected to publish community care plans outlining the development of community-based services. independent service providers and others to ensure that their charters reflected local priorities and concerns. and placing an obligation on employers to make reasonable adjustments to working conditions to enable people with disabilities to accept employment. the NHS and Community Care Act 1990 stated that health authorities would retain their responsibility for providing long-term health care for those in need. However. The charters would give service users and those involved in providing their care with better opportunities to influence service delivery. with the aim of ensuring that they remain in contact with mental health services and that their care was monitored on a regular basis. 1993 The Protocol for investment in health gain (mental health) . and indicated where reinvestment might be considered. Charters would give people clear information about what they could expect from local authorities. 1995 The Mental Health (Patients in the Community) Bill proposed new powers regarding the aftercare of people discharged from hospital. The protocol identified where further investment could bring worthwhile health gain. 1994 The Department of Health set out its Framework for local community care charters in England. They were also expected to show that they were making the best possible use of the independent sector. A 'supervisor' could convey the service user to a place where they were to receive aftercare.
disagreed with the statement that community care had failed. But it has left many vulnerable patients to try and cope on their own. 1996 The National Prescribing Centre was set up by the Department of Health to 'promote and support high-quality cost-effective prescribing and medicines management across the NHS. The NSF spelled out national standards . 1996 The Community Care (Direct Payments) Act 1996 gave local authority social services departments power to make direct cash payments to some individuals in lieu of the community care services they had been assessed as needing. a 24-hour telephone advice line on health matters. 'Care in the community has failed. management of risk. 1996 The Mental Health (Patients in the Community) Act 1995 came into force. section 25. NHS Wales: putting patients first. Frank Dobson. 1998 The Health Secretary. Discharging people from institutions has brought benefits to some. [See Mental Health (Patients in the Community) Bill above]. 1996 The Carers (Recognition and Services) Act 1996 amended the NHS and Community Care Act 1990. A small but significant minority have become a danger to the public as well as themselves. It placed a duty on local authorities to carry out an assessment of the needs of carers for services such as respite care. http://www. discharge and aftercare arrangements the use and disclosure of patient information and immediate arrangements for improving communication and continuity of care across agencies. The Act worked by creating a new section of the Mental Health Act 1983. The new NHS: modern.' Mind. including the assessment process. It also announced the establishment of NHS Direct.uk/ 1996 A survey carried out by the National Institute of Adult Continuing Education (NIACE) with further education colleges and local education authorities concluded that provision for people experiencing mental health difficulties was patchy in quantity and quality. Initially part of the Cabinet Office. 1998 The Welsh Office brought out the equivalent paper to the above for the NHS in Wales. 1999 The Government published the National Service Framework [NSF] for mental health -: modern standards and service models for England. 1997 The Prime Minister set up the Social Exclusion Unit. 1997 The Department of Health and the Scottish Office published a White Paper. which described how the 'internal market' in the NHS was to be abolished. to help improve patient care and service delivery'. to enable them to secure the relevant services for themselves. which contained new powers.co. Others have been left to become a danger to themselves and a nuisance to others. stated that.npc. the Unit moved to the Office of the Deputy Prime Minister in May 2002 and now works closely with other parts of the Office such as the Neighbourhood Renewal Unit and the Homelessness and Housing Support Directorate to tackle deprivation. dependable. along with many others.y y y the continuing role of CMHTs within the specialist mental health services the provision of care and support. to be staffed by nurses.
but the acronym remained unchanged. NICE's role is to provide patients. Managing dangerous people with severe personality disorder: proposals for policy development. which announced plans to introduce a new legal power of 'indeterminate but review-able detention of dangerous personality-disordered individuals' who present a grave risk to the public (for previous offenders and non-offenders).uk/ 1999 Section 31 of the Health Act 1999 outlined new powers to enable health and local authority partners to work together more effectively. Unfortunately. Before publishing these proposals the Government received a report from an expert committee. NICE guidance covers individual health technologies (including medicines. 1999 The Disability Rights Commission was set up under the Disability Rights Commission Act 1999. which had spent 10 months reviewing the Act. 1999 The National Institute for Clinical Excellence (NICE) was set up as a Special Health Authority for England and Wales on 1 April. (Its functions were transferred to NICE on 1 April 2005. 1999 The Government published proposals on reform of the Mental Health Act in England and Wales. chaired by Genevra Richardson. More information is available at http://www. 2000 The Health Development Agency was established as a Special Health Authority to develop the evidence base to improve health and reduce health inequalities. Mind warned the Government that plans to introduce compulsory treatment in the community would backfire and drive users away from services. (Its name was changed to the National Institute for Health and Clinical Excellence in 2005 when the Institute took on the functions of the Health Development Agency (see below). diagnostic techniques and procedures) and the clinical management of specific conditions. NICE guidelines relating to mental health issues include: y y y y y y y y y y y antenatal and postnatal mental health (February 2007) anxiety (December 2004) bipolar disorder (July 2006) dementia (November 2006) depression (December 2004) eating disorders (January 2004) obsessive-compulsive disorder (November 2005) post-traumatic stress disorder (March 2005) schizophrenia (December 2002) self-harm (July 2004) violence (February 2005). how they should be developed and delivered.) Part of the NHS. This included pooled funding and integrated provision and the creation of primary care trusts (PCTs).for mental health services. 1999 The Home Office and Department of Health produced a consultation paper. many of the more positive aspects of the Richardson report were not accepted by the Government. to come into force on 1 April 2000.nice. what they aimed to achieve. medical devices.org. health professionals and the public with authoritative guidance on current 'best practice'.) . and how performance would be measured in every part of the country.
included the proposal to abolish Community Health Councils (CHCs) in England. Empowerment.' 2000 The draft Child and adolescent mental health services strategy Everybody's Business was published in June. 2000 The NHS plan. and for reform of many sections of the NHS. This included the establishment of a National Care Standards Commission.org. An easy guide to direct payments was published in April 2000 to promote direct payments for people with a learning disability. professional organisations and trade unions lobbied Parliament to press for changes to the Government's plans for a new Mental Health Act. The Alliance wanted a new Mental Health Act that would: y y include a legal right to care and treatment result in the reduced use of compulsory powers. entitled Equity. He stated that key areas of the NSF would include: y y y y y the phasing out of mixed-sex psychiatric accommodation over the next two years the elimination of out-of-area acute admissions as soon as possible 24-hour access to mental health services for patients and carers to be in place by April 2001 setting up of a website to enable patients/users.mentalhealthalliance. The Government expressed a wish that people who currently had preserved rights to income support for long-term care costs should also be offered direct payments if they wanted to leave residential care. The final strategy from the consultation process will provide the strategic background against which an NSF for Wales (NSFW) for adult mental health services will be developed. http://www. The draft strategy stated that it was right that an NSFW should 'differ in some important respects from the English document as there are distinctive differences in emphasis that reflect particular circumstances in Wales.2000 Direct payments were extended to those aged 65 years and over. patients' forums in trusts and health authorities. 2000 The Mental Health Alliance. serviceuser groups. Managing dangerous people with severe personality disorder. Efficiency. published in July. families/carers and staff to give their views directly to Professor Appleby new training and courses in 'cultural awareness' for psychiatrists . 2000 Professor Louis Appleby was appointed as the National Director of Mental Health (widely known as the 'mental health czar'). 2000 The National Assembly for Wales published its draft adult mental health services strategy for Wales. replacing them with a range of bodies including Patient Advocacy and Liaison Services (PALS). a group of over 50 major voluntary organisations. The NHS plan promised hundreds of mental health teams to provide an immediate response to crises. The standards set should be at least as good as those set for England.uk/ 2000 The Home Affairs Select Committee's report. The NHS plan also set out plans for increased funding. and local authority scrutiny committees. service providers. Effectiveness. was published.
to ensure that unsuitable people are prevented from working with vulnerable adults. development and delivery of mental health services effectiveness: mental health services should provide effective interventions that improve quality of life efficiency: mental health services must use resources efficiently and be accountable for the way public money is spent. and began regulating services in April 2002.uk/) and the Care Council for Wales (http://www. setting out the way in which information systems would be developed to support modern mental health care delivery. http://www.nhs.org.y a drive to encourage more nurse consultants in the mental health area. It took on the four main roles suggested by the Royal Commission on Long Term Care: y y y y monitoring representing the consumer providing national benchmarks encouraging the development of better services. Northern Ireland and Eire) and the Association of Public Health Observatories (APHO) were set up as part of the Government's strategy for improving health and reducing health inequalities. The Commission established the General Social Care Council for England (http://www.our healthier nation.org.uk/ 2001 The Mental health information strategy. which includes four key principles: y y y y equity: mental health services should be available to all and allocated according to need empowerment: users and their carers to be integrally involved in planning.uk/ 2001 NHS Direct covered the whole of England.wales.nhs. More information 2000 The Care Standards Act 2000 set up the National Care Standards Commission for England. 2000 Nine regional public health observatories (PHOs) in England and Wales (and three others for Scotland. and set up the 'protection of vulnerable adults' scheme. http://www.pdf . www.apho. was published. prepared for the Department of Health by a team of people from Mental Health Strategies and the Sainsbury Centre for Mental Health.ccwales.uk/publications/adult-health-e. 2001 The National Care Standards Commission was set up in April.org. Public access was extended through NHS information points and digital TV.nhsdirect.gscc. NHS Direct Online was developed and relaunched in November 2001.uk/) to regulate social care workers (abolishing the training body CCETSW). in particular to work with people with mental ill health and drug and alcohol problems. 2001 The National Assembly for Wales launched the adult mental health services strategy for Wales. as set out in the White Paper Saving lives .
pharmaceutical. concerned with the performance of individual doctors and dentists. 2001 NSF for older people published. The Bill also addressed issues relating to training of professions supplementary to medicine. a booklet providing a short explanation for non-specialists of the policies adopted by the Government to improve mental health services for people of working age. maternal and child health. Its . and manages confidential enquiries into suicide and homicide. SURE was set up on the premise that the research priorities and perspectives of service users were different from those of people who work in mental health services. optical and dental. setting new national standards of care for all older people.uk/publications/men-health-e. establishing an Association of Welsh Community Health Councils and the development of the Wales Centre for Health as an independent training.uk/Acts/acts2001/ukpga_20010015_en_1 2001 At Mind's annual conference in Scarborough in November. It also includes the Central Office for Research Ethics Committees (COREC). 2001 Publication of the NHS (Wales) Bill.2001 The National Patient Safety Agency was established to monitor medication. Jacqui Smith. 2001 Publication of The journey to recovery: the Government's vision for mental health care. www. 2001 The Service User Research Enterprise (SURE) was set up at the Institute of Psychiatry to undertake research that would test the effectiveness of services and treatments from the perspective of people with mental health problems and their carers.gov. the Health Minister. and food. announced the ring-fencing of funding for mental health.pdf 2001 The Health and Social Care Act 2001 introduced a number of measures to modernise the regulation of Family Health Services (FHS) in relation to all four FHS contractor professions: medical. including assertive outreach teams. advisory and research body designed to facilitate partnerships with the Welsh Assembly and the public. Its remit was extended in 2005 to cover safety aspects of hospital design and cleanliness.uk/ 2001 A research and development strategy for public health was published. whether they live at home or in residential care or are being cared for in hospital. and from those of people with a solely academic background. crisis resolution teams and help for people in prisons. 2001 The child and adolescent mental health services strategy for Wales was introduced.wales. The main points were: y y y y services must be child centred good interagency working is essential a needs assessment for Wales is essential the role of the voluntary sector must be strengthened. and patient outcome and death.npsa. http://www. Its proposals included consulting health service users in developing services.opsi.nhs. the National Clinical Assessment Service.nhs. reporting of prescribing errors and other patient safety incidents in the NHS. with the aim of improving a range of community mental health services. voluntary and academic sectors. early intervention for young people. www.
Its aim was to reduce the death rate from suicide and injury (and poisoning) of undetermined intent by at least one-fifth by 2010 (from the Our healthier nation baseline rate of 9. More information can be found at http://www. Strategic Health Authorities were to monitor performance and standards. Although this legislation was not mentioned in the Queen's speech in November 2002. SCIE works closely with Government. practitioners and users.org. 2001-02 The Supporting People programme was set up.4 billion extra to be invested every year by 2004 . a coalition of over 50 organisations who shared common concerns about the Government's proposals to reform the Mental Health Act 1983.aim .000 population in 2009/10/11).uk/. the new regulatory bodies. 2002 Draft Mental Health Bill published.000 population in 1995/96/97 to 7. 2002 Publication of consultation document Women's mental health: into the mainstream. The NSF aimed to set standards for services in Wales. National suicide prevention strategy for England on the Department of Health website 2002 The 10-year National Programme for Information Technology was set up. with the publication of Delivering 21st century IT support for the NHS: national strategic . It soon changed to the Commission for Health Improvement (CHI). the General Social Care Council and the National Care Standards Commission. aiming to improve the quality of life for vulnerable people by providing a stable environment and greater independence. improve quality and reduce unacceptable variations in the provision of health and social services.org. with a focus on service user experience. Mind described the Bill's central provisions as 'unworkable and regressive'.uk/ 2002 The NSF Adult Mental Health Services . 2002 PCTs took control of local health care in April 2002. and with other social care organisations.A national service framework for Wales was developed following the publication of the adult mental health strategy for Wales. More information can be found at http://www. 2002 The National suicide prevention strategy for England was published. It established practical guidelines to ensure consistent and comprehensive implementation of the strategy's vision across Wales. 2002 Publication of Fairer charging policies for home care and other non-residential social services practice guidance. 2001/02 The Social Care Institute for Excellence (SCIE) was established by the Department of Health and the National Assembly for Wales as part of the Government's 'quality strategy for social care'. service users and support agencies.spkweb. Draft Mental Health Bill (2002) on the Department of Health website 2002 The Commission for Healthcare Audit and Inspection (CHAI) was set up to review NHS services. the Government stated its proposal to introduce it during the current session.backed by £1. as a partnership of local government. but opposed by the Mental Health Alliance.3 deaths per 100.scie. It began work in October 2001 and was formally launched in spring 2002. and later became incorporated into the Healthcare Commission. Partnership and commissioning will be key features of the new organisation.2 deaths per 100.is better health and social care services for older people.
Its immediate aim was to improve the lives of people with mental health problems by reducing or eliminating barriers to employment and wider social participation.healthcarecommission. The Bill was again opposed by the Mental Health Alliance (see 2002). placing new duties on the NHS and local authorities in England relating to communication between health and social care systems around the discharge of patients and communication with patients and carers.org.org. Draft Mental Health Bill 2004 on the Department of Health website 2004 The Healthcare Commission took over from CHI.htm 2003 The Community Care (Delayed Discharges Etc) Act 2003 was passed. see below). private health care and voluntary organisations. enable people to fulfil their . http://www. http://www. providing an independent assessment of the standards of services provided by the NHS.org. HSC 2003/009 .chre.uk/ 2004 The Healthcare Inspectorate Wales was established to review the quality and safety of patient care commissioned and provided by health care organisations in Wales.uk/ 2003 NIACE repeated its 1996 survey of provision for adults with mental health difficulties in all further education colleges and local authority adult education services in England.uk/research/HDE/Projects/NIMHE. www.niace.uk/ 2004 The Social Exclusion Unit published its report Mental health and social exclusion. and of their proposed discharge date. http://www.nimhe. It later became part of the Care Services Improvement Partnership (CSIP.uk/ 2003 Publication of Pathways to work: helping people into employment.programme. 2003 The National Institute for Mental Health in England (NIMHE) was set up 'to improve the quality of life of people of all ages who experience mental distress'. to ensure consistency and good practice in health care regulation. http://www. Pathways to work: helping people into employment on the DWP website (PDF file) 2004 Publication of a second draft Mental Health Bill. The NHS is required to notify councils of any patient's likely need for community care services.org.The Community Care (Delayed Discharges Etc) Act 2003: Guidance for implementation on the Department of Health website 2003 The Council for Healthcare Regulatory Excellence (CHRE) was established by Parliament as an independent statutory body covering all of the UK. a consultation document.csip. as part of a programme with NIMHE promoting access to adult education for people with mental health difficulties. It found that in many areas new provision was being developed for adults with mental health difficulties in a variety of settings. The programme was to include the introduction of electronic patient records under the NHS Care Records Service (PDF file). with flexible systems of support.org.hiw. The findings were published in a series of regional reports. Mind considered that most of the principles underlying this Bill were neither appropriate nor desirable. The National Social Inclusion Programme (NSIP) brought together the work of government departments and other organisations in a concerted effort to challenge attitudes.
Independence.cfm?OrgID=568 2005 Publication of the revised NSF for Mental Health in Wales. It includes the National Library for Health.socialinclusion. to be a focus for new ideas. http://www. The Safe and secure handling of medicines: a team approach (PDF file) . well-being and choice: our vision for the future of social care for adults in England on the Department of Health website 2005 The NHS Institute for Innovation and Improvement was established as a Special Health Authority. well-being and choice: our vision for the future of social care for adults in England. www.nhs. the NHS and the voluntary and community sector. 2004 Publication of Making partnership work for patients.uk/sites3/page.uk/sites3/home. which was a revision of the 1988 Duthie Report on the safe handling of medicines.aspirations and significantly improve opportunities and outcomes for people with mental health problems. Independence. the aim of which was to benefit patients. http://www.nhs. 2005 Publication of Creating a patient-led NHS: delivering the NHS improvement plan. which set out the key principles for supporting the public to make healthier and more informed choices with respect to their health and emotional wellbeing.org.uk/home/index. www. 'a vision for adult social care' over the next 10-15 years and how this might be realised.uk/ 2005 The Wales Centre for Health was established under the Health (Wales) Act 2003 as a statutory body sponsored by the Welsh Assembly Government.nhs. 2004 Publication of the White Paper Choosing health: making healthy choices easier.nhs.ic.uk/ 2005 The NHS Information Centre for Health and Social Care was set up. technologies and practices to improve services to patients.php 2004 Publication of The NHS improvement plan: putting people at the heart of public services. with responsibility for collating data and producing reports that provide the basis for decisions about the provision of health and social care. Creating a patient-led NHS: delivering the NHS improvement plan on the Department of Health website 2005 Publication of the Green Paper. produced by a multidisciplinary group of the Royal Pharmaceutical Society of Great Britain in association with the Shipman Inquiry. which set out.institute. with a broad remit of improving health in Wales. www. carers and service users 'by providing them with real alternatives so that they can choose services that best suit their needs'.wales. carers and service users: a strategic agreement between the Department of Health.wales.cfm?orgid=438&pid=11071 2005 Publication of The Safe and secure handling of medicines: a team approach. users and the public.
www. Food and Rural Affairs (DEFRA) for two years 'to develop the capacity of the rural voluntary and community and parish council sectors. Medicines use review: Understand your medicines on the Department of Health website 2005 Delivering race equality (DRE) in mental health care was launched following consultation. developed in response to the report of the independent inquiry into the death of David Bennett. so that conditions that were not regularly diagnosed by a doctor could be covered as well as well known conditions such as anxiety. making an assumption of capacity to consent to treatment in all cases unless there is clear evidence to the contrary.uk/ 2005 The Disability Discrimination Act 2005 amended the 1995 Act.csip.opsi. http://www. young people. supervised community treatment. our say: a new direction for community services. 2006 Publication of the White Paper. to address important social issues and tackle the causes of rural social exclusion. including changes to the definition of mental disorder. people in the criminal justice system and children. Two versions of the Bill (published in 2002 and 2004) had provoked strong resistance from everyone involved in the mental health system. their families and carers. our say on the Department of Health website 2006 The Government formally announced on 23 March 2006 that ministers had decided to abandon the controversial draft Mental Health Bill. 2005 The Care Services Improvement Partnership (CSIP) was established by the integration of a number of initiatives supporting the development of health and social care services for older people. our care. http://www.gov. work together to shape their own future'.org. people with mental health problems and learning disabilities.opsi.' Our health. to help specialist mental health services to improve prescribing practice. Delivering race equality (DRE) in mental health care on the Department of Health website 2005 The Rural Social and Community Programme was set up by the Department for Environment. ensuring that they are more personalised and that they fit into people's busy lives. an African-Caribbean patient who died in 1998 in a medium-secure psychiatric unit after being restrained by staff. depression. and protection of the human rights of people with mental health problems (the Bournewood . thereafter. Our health.2005 The national Prescribing Observatory for Mental Health (POMH-UK) was launched by the Royal College of Psychiatrists. the criteria for detention. It extended the definition of 'mental illness' by removing the requirement that a condition should be 'clinically well-recognised'.gov.uk/ACTS/acts2005/ukpga_20050009_en_2 2005 Medicines use reviews were initiated. our care.uk/Acts/acts2005/ukpga_20050013_en_1 2005 The Mental Capacity Act 2005 was passed. with funding from the Health Foundation. This was a five-year action plan with the aim of improving services for minority ethnic communities. to encourage people on long-term medications to discuss how they are getting on with them with a pharmacist. but made some important amendments. The programme was closed in March 2008 but elements of its work continue. bipolar disorder and schizophrenia. Instead. a new draft Mental Health Bill was published that left the existing Mental Health Act 1983 in place. so that those communities could. which promised 'a radical and sustained shift in the way in which services are delivered.
aspx 2007 Mental Health Act 2007 passed. Crime and Victims Act 2004. set out the national framework to make more choice available locally to people who use mental health services in England. targeting some of their health-related barriers and providing financial support. All sections will be in force from November 2008.3 per 100. the Commission for Racial Equality and the Disability Rights Commission.1 per 100. Mental Health Bill and related documents on the Department of Health website 2006 The Cabinet Office announced the setting up of a Social Exclusion Taskforce to concentrate on identifying those most at risk and focusing on specific hard-to-reach groups of people with mental health problems.nhs. produced by the NIMHE National Workforce Programme. using material from existing NHS websites and links to other reputable national and local health and social care organisations. The depression report on the London School of Economics website 2006 The Department of Health document.uk/welfarereform/pathways_process. merging the Equal Opportunities Commission. which set out a programme of reform to the UK's system for the regulation of health professionals. www.uk/Pages/homepage.com/ 2007 Publication of Mental health: new ways of working for everyone . The report builds on previous guidance and .uk/social_exclusion_task_force.gov.aspx 2006 Publication of Lord Layard's report. looking at ways they can work more flexibly within teams.) 2007 The Equality and Human Rights Commission was established under the Equality Act 2006. The Act made amendments to the Mental Health Act 1983. Our choices in mental health.cabinetoffice.a new programme to encourage people on long-term incapacity benefit to find work by helping them to become independent and earn a living.000 population by 2012.gov. The depression report: a new deal for depression and anxiety disorders. the Mental Capacity Act 2005 and the Domestic Violence. Mental Health Act 2007 on the Department of Health website 2007 The National Public Health Service for Wales published its aim to reduce the suicide rate to 11. (The rate was 12. based on consultation on the two reviews of professional regulation published in July 2006: Good doctors.a report aimed at all mental health staff.provisions). http://www. www. assurance and safety: the regulation of health professionals. and the Department of Health's The regulation of the non-medical healthcare professions. safer patients by the Chief Medical Officer for England.equalityhumanrights. assurance and safety: The regulation of health professionals on the Department of Health website 2007 'NHS Choices' was set up: a web-based service providing easily accessible health and health care information that can be personalised for different patients.asp 2007 Publication of the White Paper.000 in 1995. www. 2006 'Pathways to work' established . to reduce the overall cost of treatment and dependency on social security benefits. Trust. The White Paper Trust. which recommended the use of psychological therapies on economic grounds.dwp.
uk/ 2007 Publication of interim report by Health Minister. 2008 Incapacity Benefit for new claimants replaced by Employment and Support Allowance in autumn 2008. making changes to benefits for people with disabilities. A new advisory board set up to develop future strategy on primary care included Paul Farmer. for a 'ground-breaking psychological therapies service in England'. Previously only health professionals had been able to report adverse events.gov. Medicines management: everybody's business on the Department of Health website. The report was published alongside the 'Creating capable teams' approach (CCTA).promotes a model where 'distributed responsibility' is shared amongst team members and can no longer be delegated by a single professional such as the consultant.gov. The creation of the National Information Governance Board for Health and Social Care on the Department of Health website 2007 Piloting of the new Summary Care Record system (electronic patient records) sparked concern and public debate about the privacy and security of the new systems. 2007 On World Mental Health Day. a leaflet for service users and carers. Chief Executive of Mind. Health Secretary Alan Johnson announced substantial extra annual funding. Our NHS.mhra. and to help health and social care practitioners to improve their person-centred approach in the area of medicines management'. over-the-counter. especially for people whose mental health problems may not formerly have been known to other medical specialists.asp Further reading Mind factsheets and legal briefings Notes on the history of mental health care . and New ways of working with you.uk/welfarereform/employment. The public scheme allows anyone to report adverse effects of any medicine (prescribed. rising to £170 million in 2010/11. Lord Darzi. which provided practical guidance. herbal or complementary) including effects of medication withdrawal. www. and to ensure the ethical and appropriate use of them for the benefit of individuals and the public good. 2008 Publication of Medicines management: everybody's business leaflet by NIMHE. aiming to 'empower service users and carers to ask relevant questions about medication and have their views taken into account. our future which includes a proposal for the setting up of 'polyclinics' in primary care. Welfare Reform Act 2007 on the OPSI website (PDF file) 2007 Creation of the National Information Governance Board for Health and Social Care to oversee the structures. http://yellowcard. 2007 The Welfare Reform Act 2007 was passed. policies and practices that are used to ensure the confidentiality and security of records relating to the delivery of services. New Ways of Working in Mental Health on the NIMHE website 2007 The Medicines and Healthcare products Regulatory Agency (MHRA) launched the public Yellow Card scheme for reporting the adverse effects of medicines.dwp.
the NHS and the voluntary and community sector. Department of Health Consultation Response from Mind (October 2003) Making partnerships work for patients. Mind Policy and Parliamentary Unit (1999) PPU Bulletin 1: Saving lives . Mind Policy and Parliamentary Unit (2000) Mind's policy on primary care. Mind Policy and Parliamentary Unit (1999) Mind's evidence to the House of Commons Health Committee Inquiry on provision of NHS Mental Health Services.our healthier nation white paper.what progress five years on? Mind Policy and Parliamentary Unit (September 2004) HASCAS review of user/survivor and carer involvement in NIMHE. carers and service users: a proposed strategic partnership agreement between the Department of Health. Mind Policy and Parliamentary Unit (1993) Executive summary of Mind's evidence to the Mental Health Act Review Team. Response from Mind (February 2005) . Response from Mind (September 2004) Healthcare Commission Consultation. Response from Mind (November 2003) The national service framework for mental health .uk) Mind's policy on community care.A history of Mind Briefing 1: Amendments made to the Mental Health Act 1983 by the Mental Health Act 2007 Mind Policy documents (available from policyadmin@mind. Mind Policy and Parliamentary Unit (1999) Response to 'The Supported Employment Programme: a consultation on future development' . Social Exclusion Unit Consultation (Office of the Deputy Prime Minister) (September 2003) Delivering race equality: a framework for action. Mind Policy and Parliamentary Unit (1999) Summary of Mind's response to the Government consultation document "Managing dangerous people with personality disorder".org. Mind Policy and Parliamentary Unit (2002) Mental health and social exclusion: the Mind response. Mind Policy and Parliamentary Unit (1999) PPU Bulletin 2: National services framework for mental health. Assessment for improvement.
Mind. . Jeremy Laurance. 2007 Ecotherapy: the green agenda for mental health. Shunned: discrimination against people with mental illness. Mind. your say. Routledge. your care. 2002. July 2008. Response from Mind (August 2005) Your health. Graham Thornicroft. Response from Mind (October 2005) Mind response to Consultation on the Rural Social and Community Programme. Food and Rural Affairs (October 2005) DRC Consultation on the Definition of Disability. OUP. Response from Mind (February 2006) Mind's response to Lord Darzi's review of the NHS (January 2008) Consultation on Finding a shared vision of how people's mental health problems should be understood. Moira Fraser. Department of Health consultation. 2007 Pure madness: how fear drives the mental health system. Mind Policy and Parliamentary Unit (2005) Mental Health Act Commission (MHAC) race equality scheme and action plan consultation. 2006 This factsheet was originally written by George Stewart. Department for Environment. Response from Mind (March 2008) Available to buy from Mind Publications on 0844 448 4448 Another assault.Just ask the inpatients: revealing a clearer picture of acute services. updated by Katherine Darton. Mind Information Unit 1998.