Sir, The “wake-up call to British psychiatry” described in your report (“Mentally ill patients are ‘jollied along’ rather than treated by a psychiatrist”, June 27) is more likely to be a nail in its coffin.

The psychological therapies and their providers so disparaged by these academic psychiatrists are supported by evidence, the National Institute of Clinical Excellence, mental health professionals, service users and carers, and part of the reason that they are so in demand is that service users and carers feel that the traditional, medical model has let them down.

Modern mental healthcare is a collaborative, team effort; it is no longer passive patients receiving a diagnostic label with no regard to their wider social milieu, and being treated solely with medications that are not always effective or acceptable. Best practice nowadays deploys the skills of a wide variety of trained professionals to meet individual needs.

The irony is that New Ways of Working is not a government scheme but received its impetus from psychiatrists themselves, who felt overburdened with routine tasks and responsibilities. It has improved their working lives, yet now it threatens to divide them because some cannot cope with the loss of hegemony that distributing responsibility involves.

New Ways of Working is about changing working practices so that those professionals who are most highly trained and skilled work with those with the most complex needs.

There would have been no need for it if the previous systems had worked effectively and efficiently, yet as other mental health professions embrace it and move forward, gaining in skills and influence, some psychiatrists undermine their discipline by simply not listening to what people are asking for.

Intellectual rigour is to be welcomed, but intellectual arrogance and assumptions of superiority have no place in the provision of holistic mental health care.

Psychiatrists all over the country are using New Ways of Working to enable them to provide the care that people need, and the views of an academic minority should not detract from that.

Professor Peter Kinderman
Professor of Clinical Psychology, University of Liverpool

Christine Vize
Consultant Psychiatrist

Stephen Humphries
Consultant Psychiatrist

Roslyn Hope
Director, National Workforce Programme, National Institute for Mental Health in England

Sir, We strongly support the psychiatrists who claim that mentally ill patients are not receiving the care they need. This is particularly true in the case of severe or prolonged postnatal illness.

We have found that many women are having babies removed by social services as a result of inadequate mental health care which does not meet NICE guidelines. One suicidal mother was told by her GP: “We do not have to worry now: we know the baby is safe.” No wonder suicide is a leading cause of deaths associated with childbirth.

Community mental health teams are failing to refer deteriorating patients for assessment by perinatal psychiatrists, and cases of post-traumatic stress disorder, or severe bereavement reactions, continue to be inadequately treated as simple “postnatal depression”.

Jean Robinson
Association for Improvements in the Maternity Services, Oxford

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