THE DERIDED
SIR,—Welcome as is the success of the Worthing Ex- periment, it should be made clear that this is a different type of service from the community care services envisaged by the Mental Health Bill. What has been done at Worthing is to provide, in an area
previously barren of them, those peripheral services, such as out-patient clinics, domiciliary visiting and day hospital facilities, that a large mental hospital ought to provide as a matter of course for the community it serves. Such services are unfortunately far rarer than they should be, especially outside the metropolitan area, Following their introduction it would indeed be remarkable if admissions to the parent mental hos- pital did not fall sharply. The unique feature of the Worthing Experiment lies in the treatment of patients in their own homes in appropriate cases, a service that has undoubtedly contributed to the fall in admissions.
The community services for which the Mental Health Bill wills the end—though not, as you rightly point out, the means—arc primarily care services for those mentally disordered persons who do not need constant medical or nursing care, and for ex-patients. They are to be administered by the local health authorities, though there must be the closest liaison with the hospital and, one hopes, a sharing of trained personnel. Community services of this nature already flourish in such places as Nottingham, York and Oldham. The Worthing Experiment, however, does not embrace the local health authority since it is essentially a treatment service.
1 should like in conclusion to endorse your plea for more resources for mental health, for more psychia- trists and for more psychiatric teaching and research. Prejudice against psychiatry is being steadily over- come; in the House of Commons last week even the Attorney-General stoutly resisted an attack by a Tory backwoodsman on psychiatric evidence in court cases. The last-ditch battle against enlightened attitudes towards psychiatry looks like being fought within the medical profession itself. There is little the layman can do here beyond giving aid and comfort to the forces of light.—Yours faithfully,
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