During one of the recent ward rounds, we decided to discharge a patient who had a diagnosis of schizoaffective disorder. He had been on the ward for about 2 months as a voluntary patient and he was treated with antipsychotic medication. We advised him that he should continue the medication on a daily basis after the discharge in order to prevent future relapse. He said that he had to pay for prescriptions and therefore expressed his difficulty in taking the antipsychotic medication on a long-term basis.

Research by Rethink (unpublished; personal communication, 2009) shows that 26% of service users currently pay for prescriptions (56% of those who have been in paid employment over the past 12 months); 38% of people with severe mental illnesses like schizophrenia have to choose between paying household bills and prescription charges (www.prescriptionpromise.org). This group of patients will now have to pay even more due to the recent increase in prescription charges, which many already cannot afford. This grossly unjust situation can result in people not getting their medicines and as a result having a relapse of their mental illness.

Patients with chronic conditions such as hypothyroidism and diabetes mellitus are receiving free medication irrespective of their job or financial background (www.nhsbsa.nhs.uk/1126.aspx). Prescription charges have also been abolished recently for people with cancer, and the Parkinson's Disease Society has now urged the government to end prescription charges in England for people with Parkinson's disease. Why not those with enduring mental health difficulties? Although a number of patients with chronic mental health problems do get free medication owing to their poor financial status, there are patients who may have some money in the bank or other income. It is not fair to presume that all psychiatric patients do not have any money and all of them are not capable of generating an income or even not entitled to inherit wealth.

The ethos for providing free medication in chronic conditions such as hypothyroidism should be valid and applicable to those with long-term mental health difficulties.

The College, along with the voluntary sector, should actively campaign to put pressure on the government to abolish prescription charges for people with long-term mental illness.