Independent investigation: Anthony Harrison, Andover (1998)

There should be no further disinvestment in mental health promotion services, especially those aimed at improving the mental health of young people.

The Health Authority, in conjunction with Mid Hampshire PCG and the Prison Medical Service should jointly develop a Health Improvement Programme for Winchester Prison, with mental health as a priority.

The Health Authority should support the development of a prison CMHT.

Together with partner agencies, the Health Authority and PCGs should investigate the most appropriate way to provide mental health and substance misuse services to people who are homeless and who may find difficulty accessing regular services.

As alcohol misuse and drug misuse are becoming more common problems, local multi-agency strategies should be developed through the Drug Action Team and Drug Reference Groups, with appropriate links to local community safety strategies.

The Health Authority, PCGs and NHS Trusts should support local programmes for vulnerable children and families, for example through Sure Start schemes.

The Health Authority, PCGs and NHS Trusts should encourage the Education and Social Services Departments of Hampshire County Council to continue to give priority to their work to reduce school and social exclusion, for example through the Behaviour Support Plan.

The Health Authority, PCGs, NHS Trusts, Social Services and partner agencies should develop a more systematic approach to the involvement of local mental health service users and carers in the planning and development of mental health services.

PCGs and mental health service providers should consider the development of joint registers for people with severe and enduring mental illness.

The Health Authority, PCGs and NHS Trusts should support initiatives to minimise disadvantage in rural areas, including access to services.

The Health Authority and PCGs should consider the treatment of depression in primary care as a priority for clinical governance.

Mental health service providers and accident and emergency departments should develop guidelines for the referral and assessment by a mental health professional of people who self-harm.

Health and social services should ensure that all staff who work with clients who may be a risk to themselves or others have sound and regular training in risk assessment and management.

The Care Management and Care Programme Approach processes should be combined as soon as possible, taking account of the new guidelines for CPA.

Mental Health Services providers and PCGs should develop and agree referral and shared care protocols for the management of depression.

The Health Authority, PCGs, NHS Trusts and Social Services should develop: i. assertive community outreach, appropriate for a mixed urban and rural area, for people who are hard to engage in regular services; ii. alternatives to acute psychiatric inpatient care for people who may need short term crisis care, or longer term less intensive supported care; iii. a minimum of four local intensive care beds; iv. long-term low and medium-secure services.