Mental Health’s Question Of Choice

The latest attempt by the Department of Health (DH) to extricate mental health from the service ghetto it has historically inhabited was launched this week with the publication of new guidance on how users can be guaranteed improved choice and access to treatment.

In a report, Our Choices in Mental Health, published on Monday, the government outlined a new national framework that it hopes will produce much greater choice of services and treatments at a local level. The guidance, drafted in consultation with users and their carers, represents a new tier in the government’s wider NHS “choice agenda” and, if effective, could remove some of the frustration people with mental health needs have when trying to access services.

In addition to the formal guidance, a website ( has also been launched to offer online support for local services and users.

The DH says the aim is to give users the “power to choose their own path through services and keep control of their lives”. Launching the report, health minister Rosie Winterton said: “We want patients to be able to choose how, when and where to access help.”

Mental health charities have welcomed the move in principle, but concerns remain that good intentions could be undermined by cuts that have affected many mental health trusts.

A Rethink spokeswoman says: “For too long, mental health services have been run along the lines of fear and risk; people with mental health conditions should be given choice about their treatment like any other person with a health condition.

“However, Rethink questions when the words of the report will become a reality. It is ironic that the government is talking about choice within mental health but is planning to bring in mental health law that will give people less choice and mean that decisions are taken for them without their consent. Similarly, people can’t choose treatments and services that are not available. Cuts to mental health budgets have reduced people’s choices, and the very basics of what should be available according to Nice guidelines aren’t available in many areas. A principle of choice is good news, but we need reality.”