The Department of Health's 1971 Circular (HM (71) 97) and the White Paper, Better Services for the Mentally Ill (1975), had recommended the guideline of 0.5 acute beds per 1,000 population as an average for District General Hospital units. Patients with stays of more than one year, the elderly severely mentally infirm (ESMI), children, adolescents, and certain specialized units were not included. Unfortunately, planners have tended to stick to this figure, despite the fact that the recommendation was only meant as a general guideline based on known bed usage up to 1974, and some more recent downward trends in newer smaller community-based units. The suggestion that bed requirements should be modified according to local circumstances had largely been ignored, and this is not surprising as there is little information which can help planners determine the factors or their weighting which any local authority should take into account to adapt the norm for ‘local circumstances'. This led to the setting up of a working party of the College's Social and Community Psychiatry Section to make recommendations on bed norms for acute psychiatric units.
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