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The dog that failed to bark

  • Tom Burns (a1)
Summary
Summary

UK mental healh services have been distinguished by their continuity of care but recently there has been a move to separating consultant responsibility for in-patient and out-patient care. Local examples of the success of this approach have been published but there has been remarkably little careful thought about its longer-term impacts. International comparisons would suggest that there are significant potential disadvantages, including increased bed pressures. Some disadvantages, such as the poor fit with the Mental Health Act and patient dissatisfaction with structural discontinuity are already obvious. A more considered debate is called for.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Tom Burns (tom.burns@psych.ox.ac.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Department of Health. National Service Framework for Mental Health: Modern Standards and Service Models. Department of Health, 1999.
2 Department of Health. The NHS Plan: A Plan for Investment, a Plan for Reform. Department of Health, 2000.
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8 Burns T. Models of community treatments in schizophrenia: do they travel? Acta Psychiatr Scand 2000; 102: 11–4.
9 Priebe S, Badesconyi A, Fioritti A, Hansson L, Kilian R, Torres-Gonzales F, et al. Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. BMJ 2005; 330: 123–6.
10 Shaw J, Appleby L, Amos T, McDonnell R, Harris C, McCann K, et al. Mental health disorder and clinical care in people convicted of homicide: a national survey. BMJ 1999; 318: 1240–4.
11 Appleby L, Shaw J, Amos T, McDonnell R, Harris C, McCann K, et al. Suicide within 12 months of contact with mental health services: national clinical survey. BMJ 1999; 318: 1235–9.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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