The healthcare researcher, scriptwriter and jazz singer Edana Minghella, who has died aged 63 of endometrial cancer, played a key role in restoring faith in community care of people with mental illness after public confidence was shaken by a series of scandals in the 1990s.
Governments had for 30 years been pursuing a policy of closing the UK’s long-stay mental hospitals and instead supporting people in the community through therapies, practical support and slow-release medication. But a chain of serious incidents, including the 1992 killing of Jonathan Zito by Christopher Clunis, prompted growing calls for the policy to be reversed.
Minghella, who was program lead at the then Sainsbury Center for Mental Healthheaded a team that evaluated a new approach pioneered in north Birmingham, under which crisis resolution teams provided 24-hour rapid response to people suffering psychotic episodes, or thought to be posing a risk to themselves or others.
Her report, Open All Hours (1998), found that this approach enabled people to remain safely in the community, was just as effective as hospital treatment, but far less costly, and was greatly preferred by most individuals. As a result, the scheme was recommended the following year in the official National Service Framework for mental health and, in 2000, it became a central plank of the Labor government’s NHS Plan.
This pledged the establishment of 335 crisis teams across England over the following three years and guaranteed that anyone in contact with specialist mental health services would be able to contact a team at any time, forecasting a consequential 30% reduction in pressure on acute inpatient units.
Although this optimistic forecast was never realized and the original model came to be watered down, especially when austerity hit the NHS later that decade, crisis teams remain central to NHS mental health care provision, and the threat to community-based care has receded.
Born on the Isle of Wight, Edana was the daughter of Gloria (nee Arcari) and Edward Minghella, who ran an ice-cream business, cafe and hotel in Ryde. The third of five siblings, including her film director brother Anthony, she attended St Therese Presentation convent school and, for A-levels, Ryde high school. The children helped out with the family business from an early age and became confident in handling customers of all kinds, not least those with health and addiction issues drawn to a seaside resort that was by then tipping into decline.
After a false start on a drama degree at Hull University, where Anthony had also studied drama and was lecturing, Minghella returned to the island and worked in a care home before undertaking a four-year sandwich degree course at Brunel University and the Bethlem Royal and Maudsley hospitals in south London, qualifying as a mental health nurse in 1982 and graduating in psychology and sociology the following year.
A fellow student on the course was the comedian Jo Brand, who admits to having envied the ease and speed with which Minghella picked up the skills of mental health nursing. The two became lifelong friends, with a shared commitment to fun and feminism, and were later even to perform together. Minghella also met social work student Toby Dickinson at Brunel, marrying in 1985. The union later ended in divorce.
Minghella worked as a mental health nurse, service manager, tutor and lecturer at King’s College London, taking a teaching qualification at Surrey University, until she joined the Sainsbury center in 1994. As well as her work on crisis teams, she led influential research into the effectiveness of so-called assertive outreach, working with people considered hard to engage via conventional mental health services.
It was at the Sainsbury center that Minghella worked alongside Heather Harper, who became her partner for the rest of her life, sharing a home first in Brighton and, from 2018, in the Liguria region of Italy.
In 2001 Minghella was awarded a doctorate in mental health studies at Middlesex University and moved to the Audit Commission, the public spending watchdog, where she became head of mental health but also co-authored a groundbreaking study of failings in services for disabled children and their families.
As in all her work, she was indignant and outspoken on behalf of people ill-served by the state. But she went further, bringing children with disabilities into the research process itself through what was at the time still an innovative idea of forming a reference group for the project.
After a brief secondment to the new but short-lived Healthcare Commission, which took over some of the Audit Commission’s functions, Minghella left full-time employment to work as a consultant. She continued to produce definitive research and analysis, co-developing and writing national guidance on commissioning services for dementia and extending her interest in care and support for people with personality disorders, learning disabilities and/or autism.
One of her last studies, published in 2020, was a typically incisive report for social change agency NDTi – where she was an associate – on the persistent problem of people with mental illness in need of hospital care being sent long distances from their home areas.
The greater flexibility of consultancy work enabled Minghella to develop other interests. She co-wrote with her younger brother, Dominic, much of the second series (2005-06) of the popular ITV drama Doc Martin, ran writing workshops in Italy and, above all, fulfilled in later life a long-held ambition to sing jazz professionally.
Encouraged and assisted by the established singer Liana Carrollwho was subsequently to produce her two albums, Still on My Feet (2011) and All Or Nothing (2016), Minghella put together an accomplished band and became a regular performer at leading jazz venues in London and the south-east. Singing enabled her to give free rein to her effervescent personality, and her distinctive voice and fresh interpretation of jazz standards were widely acclaimed.
After moving to Italy, her love of which she shared prolifically and infectiously on social media, she returned occasionally to perform in the UK. However, the Covid pandemic and her cancer were to restrict opportunities in recent years.
She is survived by Heather and by Edward, aged 101, Dominic and her sisters Gioia and Loretta.