4.Review of “Locality Services in Mental Health” Sainsbury Centre Booklets 1998

This review  from the British “Psychiatric Bulletin”puts the next five reports in context. They are a package of five-all dealing with innovative changes in Birmingham England–a powerhouse of mental health services innovation. Psychiatrist Louise Guest describes the reconfiguration of the system into primary care mental health teams; home treatment teams; and assertive community treatment teams. Emphasis was put on offering safe alternatives to hospital admission. Evaluation showed a 40% reduction in occupied bed days in 3 years. She questions how much of this was the result of the enthusiasm , hard work and gate keeping to the in-patient unit of the home treatment team rather than the intervention itself is unclear. I would suggest that this should not be an ” either-or” issue; it is becoming clear that it is not just enough to set up these teams-there has to be real commitment and creativity in engaging disturbed patients and their families to achieve the greatest reduction in bed usage Locality Services in Mental Heath Review