This chapter examines the delivery of community care services. It discusses services for mentally disordered persons; the entitlement, nature, and scope of the duties owed under the National Health Service and Community Care Act (NHSCCA 1990); alternative mechanisms for securing services; and the use of personal budgets and direct payments. The chapter argues that most of the time, local social service authorities and National Health Service bodies do cooperate reasonably well in the delivery of community care services, particularly for service users with learning disabilities. The draft the Care and Support Bill holds the potential to radically simplify the legal framework in which community care services are delivered, making the system more transparent and intelligible to both users and professionals. The increased use of personal budgets and direct payments could empower service users in a way that has not been possible in the past.
Chapter
3. Community Care
Chapter
2. An Overview of the Contemporary Mental Health System
This chapter begins with a sketch of the contemporary mental health system, and then discusses the rise and fall of asylum-based provision, the development of community care, and life inside a psychiatric facility. It argues that the mental health system will continue, as it always has done, to be framed in terms of the negotiation of a balance or compromise between our bi-focal response to mental disorder, prompted both by concern about the plight of fellow human beings and by a desire to control behaviour judged to be dangerous or antisocial.
Chapter
10. Control in the Community
This chapter examines the extent, scope, and current usage of the various powers by which some degree of compulsion can be imposed on a patient to accept services in the community. It discusses leave and recall; guardianship; community treatment orders; and after-care under s. 117 of the Mental Health Act 1983.
