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'Better services for the mentally ill' white paper

Move to community care

Following on from the 1971 white paper Better services for the mentally handicapped, the 1975 white paper Better services for the mentally ill also emphasised the importance of improving community provision of services for those with a mental illness. It also highlighted the need to move away from an institutional model of care.

Specialist care was mainly available in large and geographically remote mental hospitals that had been designed for custodial care. This was criticised in Enoch Powell's famous 'water tower' speech in 1961.

A social issue

The white paper suggested that mental illness was not simply an issue to be dealt with at a hospital level, but was instead a social issue. Some 5 million people in England consulted their general practitioners about a mental health problem, with others seeking support from social services. Most of those people were not referred for specialist services beyond primary care.

Policy objectives

The white paper set out the government's policy objectives, which included:

  • expanding local authority personal social services, which would enable councils to provide residential, domiciliary, day care and social work support
  • relocating specialist services from large, remote institutions to local settings
  • establishing organisational links between social workers and staff in residential care, day centres and primary care services
  • improving staffing levels to ensure patients were being assessed on a multi-professional basis to allow for early intervention and prevention.

Although the white paper emphasised the need for a move away from institutional care to community care, it noted that even local services might not be integrated with the community.


House of Commons.
Mental Health Services. 26 January 1976, Volume 904.
Hansard; 1976.

Department of Health. Better services for the mentally ill. HMSO; 1975.