The contributors to this book have provided us with a wide overview of the current development of mental health emergency services in the 1990s. The different approaches and philosophies of care described reflect the current state of flux in service provision. However, there is a broad consensus on two major aspects of service provision. Firstly, many of the contributors have emphasised that a crisis service cannot stand alone, but must be viewed as an essential and integrated component of a comprehensive mental health system. No service can be complete without an adequate crisis service, but equally a crisis service cannot function without back-up and support. Secondly, it is clear that the development of a successful service is dependent on detailed strategic planning. Every area must assess the needs of the local population and plan services on this basis. There can never be a universal model to apply everywhere. Although many of the specific types of service described in this book can be widely adopted, the proportion of resources allocated to different aspects of the service, and the pattern of integration and communication must be decided locally.

In this chapter we will attempt to summarise the main themes which have emerged by briefly discussing the roles of different key groups and by suggesting priority action plans for the future.

Purchasers

In Britain, and elsewhere, purchasers of health care have an increasingly influential role in shaping the future development of services.