Introduction

In 1998 the Joseph Rowntree Foundation funded three workshops organised by the Royal Borough of Kingston Community Services Directorate, aimed at improving partnership working. The workshops took place in May to July. Forty-five staff attended, from a wide variety of professional backgrounds, including nursing, social work, mental health and housing. This chapter explores the background to partnerships in housing and mental health, examines themes that emerged from the workshops and discusses the implications of the lack of direct input from voluntary and community organisations and service users.

Mental ill health is so common that at any time around one in six people of working age has a mental health problem, most often anxiety or depression. However, there are significant numbers of more severe and enduring cases. In addition, some 50% of people with mental health problems also have significant physical ill health. Nevertheless, over 90% of those who consult their GP with a mental health problem will never be referred to specialist services (Poxton, 1999). Not only are most people with mental health problems cared for by their GP and primary care team, that is what the majority prefer (DoH, 1999a). The aim of supporting people in the community therefore depends crucially on an integrated approach between health, social services and housing authorities.

Since 1997 the government has developed a range of policies for modernising health and social services, making primary care and partnership working central to the NHS and emphasising ‘best value’ in social services (DoH, 1997, 1998a). For mental health services these policies are underpinned by Modernising mental health services (DoH, 1998b), which identified the main problems as: inadequate care and support for people with common and severe mental health problems; some users with complex health and social care needs being socially isolated and difficult to engage; inadequate systems, poor management of resources and underfunding; overburdened families and carers; problems in recruiting and retaining staff and poor staff morale; an outdated legal framework, which has failed to support effective treatment outside hospital (Davidson, 2000).

The government’s current mental health strategy is driven by the National Service Framework for Mental Health. This sets out a series of national standards to help shape local mental health service delivery and to improve the quality of mental health services for service users and their carers. It also aims to remove the wide variations in provision nationally.