Managing mental health services seems a bit of a contradiction in terms really. Patients' needs and demands pull in one direction and government policies, such as the National Service Framework and Clinical Governance, seem to be pulling in the other, with homicide inquiries just pulling us down. With restrictions on resources, especially of trained staff, management can seem to be like organising the bailing out of the Titanic using buckets. But Reynolds and Thornicroft make a brave attempt at describing what it is possible to do.
Since this book was published, as they predict, change has occurred at such a rate that parts are inevitably looking dated (for example, Clinical Governance and the Framework, developed under Thornicroft's chairmanship). However, these authors have at least been in a good position to predict the likely and considerable demands arising from these developments and take them into account in their advice.
The book is clear, concise and readable. It is also brief and basic, but it does provide signposts to relevant literature. It is a valuable introduction to the subject, although it skirts around some of the most problematic management issues, such as those involving the relationship between doctors and managers and other mental health workers. Creative management of beds and other resources, recruitment and the development of integrated counselling/psychotherapy networks are also key issues that are not considered — as is how to avoid spending all your time in meetings and working groups without seeming inaccessible and arrogant.
Skim it, read it, buy it, but whatever you do, look at the cartoons (from Private Eye): they're great.
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