Copying letters to patients

Editor—Copying letters to patients is more exciting and more challenging than Essex allows in his perspective.¹ How sad that he chooses to single out groups that he thinks make “most objections to copying letters to patients”: administrators, providers of health services to adults, and mental health professionals. He says that mental health professionals rarely communicate with others, commenting that “no one knows what they do, and they can't be accused of not sending copies of letters if there are no letters.”

Mental health professionals have been providing copies of the care programme approach plans to patients and carers for many years. This documentation normally includes assessment of need, the care programme (who is carrying out what tasks as well as including drug treatment and side effects), a contingency plan (what to do to prevent something going wrong), and crisis plans (what to do in a crisis if things do go wrong).

Essex may also not be aware that psychiatrists have been preparing detailed reports for mental health review tribunals for many years and that these reports have been routinely made available to the patient; only on rare occasions is a piece of information kept hidden after an assessment of risk.

I am optimistic that mental health services in general, and psychiatrists in particular, will be enthusiastic supporters of copying letters to patients, provided that the operation of the process is planned properly and rare risk exceptions in which the patient or others could be seriously harmed are carefully articulated.