Evaluating community care

BARELY a week goes by without a highly-publicised incident involving an ex-psychiatric patient. The media headlines proclaim yet another failure of community care and serious incident inquiries blame inappropriate discharge from mental hospital, failure to detect risk and poor co-ordination of services. The story is so familiar that the average member of the public could be forgiven for thinking that mental health professionals spend the day with their feet up reading the newspapers, barely looking up as their patients wander off into the streets to assault an unfortunate relative or member of the public. If the media representation is inaccurate, what is the reality? Are mental health services really failing to meet the needs of some of society’s most vulnerable individuals? Or are they doing a valiant job in difficult circumstances? Unfortunately, no-one really knows. There is remarkably little information as to whether patients seen by mental health services get better, happier, sadder, madder or badder as a result of their treatment.