Too many people with mental health problems get better in spite of mental health hospitals rather than because of them, according to a new book by mental health experts at the University of Birmingham.

“Mental Health Policy and Practice”, paints a picture of a mental health system that still often fails to meet the needs of patients and their carers.

The book’s co-author Dr Jon Glasby said: “Looking at the history of mental health care in the UK, it is clear that problems facing services have changed very little over the years. Lessons from the past have not been learned, which has meant that the quality of care has not improved as it should.

"There is still a stigma attached to mental health problems, which unfortunately affects patient care. Negative public attitudes towards people with mental health problems mean many patients are excluded from making decisions about their own treatment.

"The book does recognise the extra injection of cash into services over the last few years, but given the history of underinvestment in mental health, we are starting from a very low base. It is also hard not to avoid the conclusion that changing the structures of mental health services will not be effective without a significant shift in public attitudes.”

Dr Helen Lester and Dr Jon Glasby – a GP and a social worker - provide a thorough and hard-hitting examination of the history, current state and wider context of Britain’s mental health services. The book looks at a range of key issues that have dominated thinking in mental health over the decades.

The book also highlights a number of failings such as the support and funding for community care. The system requires family members to play an important role in caring for those with mental illness, but provides very little extra funding to help them.

Dr Helen Lester said: “Although there are significant failings in the system, it isn’t a wholly negative picture. We also highlight a number of examples of excellent practice, and initiatives to involve patients in a meaningful way in their care. In recent years the government has also given mental health services a higher priority in terms of policy focus and funding. However, there is still a significant gap between government rhetoric and reality. The plan to provide 1000 Primary Care Mental Workers by 2004 is a good example of this problem. Despite a written commitment, two years after that deadline there are still only 600 people in this role. This kind of shortfall can only be solved with greater commitment at all levels of the NHS to mental health and continued investment.”


For further information or to arrange interviews contact:

Ben Hill, Press Officer, University of Birmingham, tel 0121 414 5134 or 07789 921163 or

Dr Jon Glasby and Dr Helen Lester are available for interview.

Notes to Editors:

Mental Health: Policy and Practice by Helen Lester and Jon Glasby, is published in paperback by Palgrave Macmillan, priced at £18.99.

ISBN 1-4039-3543-2

To obtain a review copy, commission an article or discuss extracts, please contact Lisa Dunn, tel 01256 302813 or email

Dr Helen Lester

Helen Lester is a Reader in Primary Care Mental Health in the Department of Primary Care, University of Birmingham, UK and the national primary care lead for the Mental Health Research Network.

Helen has published over 70 papers, chapters and books most of which are focused on mental health policy and practice, health inequalities, service user involvement and, more recently, health outcome measurement.

Helen has been a GP in inner city Birmingham for 15 years, providing primary health care for hard to reach groups including homeless people and, more recently, asylum seekers and refugees.

Dr Jon Glasby

Jon Glasby is head of health and social care and a senior lecturer at the Health Services Management Centre, University of Birmingham.

A qualified social worker, he is also a member of the national evaluation of the costs and outcomes of intermediate care commissioned by the Department of Health and the Medical Research Council (2002-2005), and a board member of the Social Care Institute for Excellence.