Policies, Priorities, Opportunities and Barriers in Mental Health Services: five years of the London managers' survey

Since 1996, an annual survey of senior managers of mental health services in London has been undertaken in order to identify trends in their views of their task. This is the only longitudinal study in the current literature of the views of a group of health and social care managers in England. This paper first outlines the methods and the findings of the survey in 2000, drawing comparisons with data collected in 1998 and 1999 (and occasionally earlier). The discussion section draws out the central themes that emerge from the surveys: firstly, community mental health teams hold a central role in the mental health system; secondly, the development of trust between agencies is a complex challenge; thirdly, it appears that social care managers may be more committed to implementation of national policy than their health colleagues; fourthly, personal and organizational instability is a fact of life; and finally, the relationship between the promulgation of national policy and its adoption into local practice is not straightforward. The conclusion reflects on the potential implications of these findings for the future development of mental health services in England.