ABSTRACT
London is one of the world’s great cities, and with other large conurbations it shares a mix of concentrated urban social diversity that both produces the high levels of demand for mental health services, and requires a subtlety of response commensurate with the needs of its populations. In this chapter we shall give an overview of the national context of mental health services in the UK, describe the particular socio-demographic features of London which are important to understand mental health needs, and summarise the results of a recent study which is the most detailed account yet undertaken of the conditions and the adequacy of the services providing psychiatric treatment and support in the capital (Johnson, Ramsay, Thornicroft, Brooks, & Lelliot et al., 1997). We paint a picture which is a mosaic composed of fragments of excellence, surrounded by a background tone of a service stretched to its maximum capacity. In the final chapter of this book we shall compare London’s services with those featured in the other chapters, in terms of resources, performance and quality.
