The featured paper is a Department of Health publication ‘Breaking down Barriers‘. This is a report by Professor Louis Appleby, National Director for Mental Health. In the introduction there are a number of statistics about prevalence of mental illness in the UK and the costs of mental illness are estimated at 77 billion pounds each year in loss of earnings. There follows a personal account of the transition from hospital based care to care in the community and some of the early difficulties that were identified. There is then a second phase where specialised service development supports the community care model and this is supported with clinical vignettes. The subsequent phase described as breaking down barriers – alluded to in the title – is then explained including the role of community development workers. The concept here is to create a more fluid interface between primary and secondary care so that people can more easily access the services that they need. There is then a discussion of the benefits that new technology has brought and the New Ways of Working Model is also discussed together with some very interesting comments from Psychiatrist Dr Michael Phelan. The document finishes with improvements in patient safety before the final conclusions which include a look at social changes which may impact upon mental health. The document is in an accessible language and easy to understand for lay readers. At the same time the document does an impressive job of summarising many of the complex changes that have taken place concisely and it is interesting to see personal experiences of a changing system.
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