A judge has warned of the "appalling human suffering" -- including
suicide and homicide -- that could result from too many hospital beds for
the mentally ill being closed for good.
Lady Cosgrove, Scotland's first woman judge, said the implementation of
care in the community, which meant the discharge of the mentally ill from
hospitals into the outside world, left "much to be desired" in
some areas.
Community care should be pursued "with enthusiasm tempered with caution",
she said.
Lady Cosgrove sounded her warning in a lecture in Glasgow last night, in
which she also spoke of the "urgent need" for new mental health
legislation, an area where the law was "fragmented, uncertain and
archaic".
Lady Cosgrove, who chaired the Mental Welfare Commission for Scotland before
her appointment to the bench in July, said community care was a good policy
but needed to be properly funded and organised if it was to provide long-term
benefits.
Declaring that for many patients the return from mental hospital to the
community could create "a nightmare with terrible consequences",
she said there was a danger of closing down too many hospital beds -- with
the result that re-admission to hospital could be difficult to achieve
for those with deteriorating health.
"The safety net of a fast-track route to hospital must not be removed
from the system," she said. "Patients who do not prosper in the
community must be able to catch the revolving door which leads them back
into hospital.
"If they cannot do so there will be appalling human suffering including
suicide and homicide.
"In short, the notion of community care as an all-embracing solution
to mental illness should not be allowed to flourish," said Lady Cosgrove,
delivering the annual James Smart Memorial Lecture to Strathclyde police
in Glasgow.
"We must not underestimate the need for sufficient hospital beds,
nor should we ignore the grim and impoverished atmosphere of many of our
major psychiatric institutions."