The national service framework: a scaffold for mental health

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Abstract
The National Service Framework for Mental Health, part of the programme to establish better quality and reduce unacceptable variations in the NHS,1 has just been published.2 This, an accompaniment to the introduction of the National Institute of Clinical Excellence (NICE), sets new standards for the delivery and monitoring of mental health services. In his introduction Frank Dobson, the secretary of state for health, claims that these national standards are founded on “a solid base of evidence” provided by the external reference group (chaired by Professor Graham Thornicroft of the Institute of Psychiatry). Mental health services have always had difficulties in setting standards, because of uncertainty over whether subjective patient oriented 3 4 or external “service” outcomes of mental illness 5 are preferable, so the framework has set itself ambitious objectives. Has it succeeded? The answer is the same as the response to asking whether it is wiseto plant a tree in a desert. It seems churlish to give …

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