Psychiatric Bulletin (2007) 31: 117. doi: 10.1192/pb.bp.106.011171
© 2007 The Royal College of Psychiatrists
Mental Health Policy and Practice
Frank Holloway, Consultant Psychiatrist
Bethlem Royal Hospital, Beckenham, Kent, email:
f.holloway{at}iop.kcl.ac.uk
H. Lester & J. Glasby Palgrave Macmillan, 2006, £18.99, 260 pp.
ISBN: 1403935432
This clearly written book by two academics (one a general practitioner and
the other with a social work background) seeks to provide an overview of
important developments in mental healthcare. Two introductory chapters set the
scene, providing the reader with a somewhat unreliable history of mental
healthcare in England and a breathless account of mental health policy over
the past 30 years. Four service-related chapters follow, encompassing primary
care, community mental health (a whirlwind tour of hospital closure, community
mental health teams and the new functional mental health teams), hospital
mental health (i.e. acute beds) and forensic mental health services. We are
then treated to a quartet of chapters on meta-issues that preoccupy
contemporary policy makers: partnership working, user involvement,
antidiscriminatory practice and carers.
Every potential reader of this book will find something they did not know.
I was completely ignorant of the literature on the pitfalls of partnership
working and read this chapter with great interest. Perhaps unsurprisingly
given the books scope there are errors of fact and misinterpretations
of the literature. Lord Ashley, when he stated that asylums would
effect a cure in seventy cases out of every hundred, was using an
evidence base at least as firm in its day as anything that has come out of
North Birmingham in the past decade. Enthusiastic as we are about locking
people up in the UK, the prison population has not as yet reached 140 000. To
call shell shock post-traumatic stress disorder is an
anachronism. To aver that those who take a biomedical approach towards mental
illness espouse mindbody dualism is surely to
misunderstand both concepts.
The authors identify three theoretical frameworks through which much of
their material is interpreted (the social model of disability, the recovery
paradigm and communitarianism) and quote generously and approvingly from a
wide range of texts that take what is fashionably termed a critical approach
to established practices in mental health.
I predict that the book will sell well, inform many and perhaps mislead a
few.