M ental I llness C oncerns A ll	Inquiry Dimond; Feza M is in the same Authority area. There also a new immigrant culture has to match a locally institutional service. Although not racialy exclusive the different backgrounds in family and neighbourhood connectuions and sources of advice and support are quite different. In inoffensive general terms -here the wife and her network - are not assertive or familiar with 'speaking out' on their own behalf. The Consultant here is also from a particular cultural background. The Feza Inquiry emphasised the poor Trust management of a CPA programme and wanted prompt attention. What was promised and achieved in response seemed praiseworhty. But three years on and the Care programme Approach just is not in place. The immediacy of self criticism immediately after an Inquiry report dissipates, and the old complacency returns. Point contact is all that happens. There is no gathering in from the community of any significant contact, active reqching out being crucial in an ethnic community. Yet again the information was there - a significant person was available - the report of the sister-in-law of the wife about violence to her based upon morbid jealousy - and information from the community care of JH, the brother , but there is no - already in place -avenue in, available to those who should become aware of it. Feza M makes the same point - Feza M did not go to the official day centre - preferring the gathering points of his minority community - which got little official recognition or contact. What SH did was to go to his guiding religious contact and become more and more prepossessed with that. When combined with schizophrenia a dangerous portent in itself. A mental health community team where half the population is from other cultures, has the professional necessity to go into an ethnic community and find out 'the system' there. To an extent ethnic communities hide their own problems within the family, mostly on the male side. Information has to be sought from the family which watches out for the weaker side. A community team must claim authority to find out. As in Barlow; Taylor management has protocols and schedules, here thinks things are going along alright, but does not visit the coalface activities and have no means built in place to monitor the practice of good theory. Management is a failure. There are simple things that can be done. A weekly meeting of the catchment area team is now commonplace, and a register of who attends, and documentation of what is raised within the meeting, gives management a tool to a kind of supervision. Management can set up and sustain the administration of the meetings.The lead clinical decider must be there. Locums can be instructed to attend and be brought up to date by the team in progress. Locums are in their nature unknown in quality. Team managers in that situation need helpful mentoring. Long term locums are a lazy management answer. They deprive the mental health service of the presence of someone who knows there will be consequences for them to face up to in the future service. Loyalties are not developed and the oft saving informal network does not obtain. A regular meeting well established and known widely to happen, means it is easy for any irritating feeling that things are not right in catchment work, to find an airing, and when well established in the community awareness, becomes known as the way to feed in information to a review process. Nobody seems interested here. A previous Chief executive of the Trust said that it was unlikely that others than those directly involved had ever seen the previous Feza M Homicide Inquiry Report let alone paid any attention to its recommendations. Psychiatrists aaand psychiatry, seem to have lost clout generally and given up leadership and direction - and responsibility - in the face of splitting of authority and diffuse accountability in community mental health teams, and have buried their heads in the protective sands of 'confidentiality', and in the development of collusive 'trust in the therapeutic alliance'; often a misplaced confidence, and not what the patient would want or be able to foresee when well, before becoming ill. Thoroughness, seizing the job, seems to have gone. back to Inquiry SH	E-mail reaction is welcome mica@didgy.freeserve.co.uk