Calls for an inquiry into over 2000 mental health inpatient deaths in Essex originally came from bereaved families. The Lampard Inquiry was eventually established and an evidence-gathering phase began in September 2024. As of July 2026, the Inquiry had heard commemorative evidence from 71 families; and received 81 written statements plus 43 oral testimonies from families. Evidence gathering is ongoing.
One of the two NHS Trusts being investigated has spent £13.5 million so far to cover costs of the process and is forecasting a final spend of £30 million. The Inquiry itself reported expenditure of £7.5 million over one year alone (2024-25). The Inquiry chair is currently considering whether to make interim recommendations based on the evidence gathered to date and there is no published timeline for next stages of the Inquiry. With this level of financial and emotional investment, it seems reasonable to wonder what the Inquiry will change; indeed, families involved have raised concerns the Inquiry will not deliver what it promised.
The Inquiry is considering various aspects of failings including delivery of treatment, involvement of patients, ward safety, staff conduct, staff training, leadership, organisational culture and complaints handling. Another aspect of care the Inquiry will consider is:
“how and the extent to which families, carers, or other members of a patient’s support network were engaged with and involved in decisions in relation to the patient’s care, including any engagement after the patient’s death”
Involvement of families in mental health care has long been mechanistic in European health systems. In 2020, we examined carer involvement polices relating to depression and concluded that national guidelines tend to reflect a highly simplified concept of family life and are based on a very narrow evidence base, ignoring qualitative research highlighting the complexity of family life. Our review of this evidence discussed the way that family involvement in mental health care can be a “double edged sword” in that benefits depend on prior family cohesion and whether family views of mental illness and treatment options align with the patient’s own perspective; in some instances, family involvement can be harmful and denigrate patient autonomy. Findings point instead to the benefits of family or couple therapy rather than a transactional form of “carer involvement” in which implementation of guidelines serves to co-opt family members into a surveillance role on behalf of the medical profession and state.
Illustrating the complexity of parent-child dynamics, another review of research found that parents describe caring for a child with mental illness as a profound and life-changing experience characterised by loss, emotional turmoil and enduring responsibility. Many experience transformation of the loved child, perceiving their child as simultaneously familiar and unfamiliar, resulting in grief, ambiguous loss and mourning for lost hopes, relationships and family life. This is accompanied by a psychological tsunami of emotions, including shock, guilt, fear, helplessness, shame and chronic sadness that often persists throughout the illness trajectory. These experiences could not be managed effectively by implementing naive “carer involvement” policies like those recommended in current guidelines.
Another more recent review of research concerning parent and family determinants of youth mental health highlights the bidirectional parent-child interactions which can influence treatment outcomes; and the role of “contemporary parenting challenges”. These include parents needing to manage children’s frequent digital technology use alongside adolescents’ drive for autonomy while parents are themselves overwhelmed by economic pressures, domestic violence, conflict or their own mental health problems. The review concludes that psycho-educational parenting interventions and targeted family interventions have significant potential to leverage parent-child warmth and affection, improving youth mental health through building parent resilience and negotiating intricate family dynamics.
Originating in Finland, Open Dialogue is a form of mental health treatment involving families directly in patient care and requiring all staff involved to have training in family therapy. This year, the first fully randomised trial of Open Dialogue published its findings, showing that the approach can significantly reduce inpatient hospital admissions. Evidence on other forms of family and couples therapy continues to emerge but has received much less investment to date than research on individual forms of therapy such as CBT. Family and couples therapy is also considerably more scarce in the NHS than individual treatments, in spite of growing evidence of effectiveness.
The Lampard Inquiry covers inpatient deaths in Essex between 2000 and 2023. Our study of the experiences of parents whose children were admitted to inpatient wards was undertaken during 2022. Most of the 15 participants had children admitted to adolescent wards in Essex (a few were admitted to wards in Cambridgeshire). We found that parents of children receiving inpatient psychiatric care face overwhelming distress; they fear their child may die or never recover and feel that their pain goes unrecognised by those around them. Relationships with services, professionals and partners become strained by conflict and any initial relief on admission gives way to complex feelings of grief and loss. Again, these overwhelming challenges would not have been avoided by ticking the “carer involvement” box.
Taking all this into account, the remit of the Lampard inquiry to consider how families are “engaged with and involved in decisions” does not seem likely to do justice to the complexity of family relationships in the context of inpatient mental health care. It seems to re-enact the naivety of welfare state policy and guidelines which prescribe “involvement” as though this offers an unambiguous course correction. Given the growing body of evidence pointing to the potential for family-based treatments rather than mere “involvement”, we suggest the Inquiry could consider how it might avoid replicating the naivety of the individual lens that has dominated mental health care for over a century in western welfare states including the UK. Given that population mental health continues to worsen, it would seem the individual lens is not working, with or without “carer involvement”. Mental health needs to be understood within the context (or lack) of family life, recognising the potential of family interventions that go beyond mechanistic “involvement”. While Lampard may deliver certain forms of justice if run well, it cannot lead to meaningful systemic change without recognising that UK mental healthcare has an in-built misconception of families.
About the authors: Suzanna Greally is a Clinical Psychologist working in Cambridgeshire and Peterborough NHS Foundation Trust, with research interests in child and adolescent mental health and family caregiving. Her work focuses on understanding and supporting the experiences of parents and families navigating mental health services for children and young people. Jeppe Oute is an Associate Professor at the University of Southern Denmark specialising in mental health, community psychology, and addiction research. His work examines how social, organisational, and policy factors shape mental health care, recovery, and lived experiences of mental distress.
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UK mental healthcare has a problem with families. The Lampard Inquiry won’t fix it.
by Susan McPherson, Suzanna Greally and Jeppe Oute Sep 23, 2026Calls for an inquiry into over 2000 mental health inpatient deaths in Essex originally came from bereaved families. The Lampard Inquiry was eventually established and an evidence-gathering phase began in September 2024. As of July 2026, the Inquiry had heard commemorative evidence from 71 families; and received 81 written statements plus 43 oral testimonies from families. Evidence gathering is ongoing.
One of the two NHS Trusts being investigated has spent £13.5 million so far to cover costs of the process and is forecasting a final spend of £30 million. The Inquiry itself reported expenditure of £7.5 million over one year alone (2024-25). The Inquiry chair is currently considering whether to make interim recommendations based on the evidence gathered to date and there is no published timeline for next stages of the Inquiry. With this level of financial and emotional investment, it seems reasonable to wonder what the Inquiry will change; indeed, families involved have raised concerns the Inquiry will not deliver what it promised.
The Inquiry is considering various aspects of failings including delivery of treatment, involvement of patients, ward safety, staff conduct, staff training, leadership, organisational culture and complaints handling. Another aspect of care the Inquiry will consider is:
Involvement of families in mental health care has long been mechanistic in European health systems. In 2020, we examined carer involvement polices relating to depression and concluded that national guidelines tend to reflect a highly simplified concept of family life and are based on a very narrow evidence base, ignoring qualitative research highlighting the complexity of family life. Our review of this evidence discussed the way that family involvement in mental health care can be a “double edged sword” in that benefits depend on prior family cohesion and whether family views of mental illness and treatment options align with the patient’s own perspective; in some instances, family involvement can be harmful and denigrate patient autonomy. Findings point instead to the benefits of family or couple therapy rather than a transactional form of “carer involvement” in which implementation of guidelines serves to co-opt family members into a surveillance role on behalf of the medical profession and state.
Illustrating the complexity of parent-child dynamics, another review of research found that parents describe caring for a child with mental illness as a profound and life-changing experience characterised by loss, emotional turmoil and enduring responsibility. Many experience transformation of the loved child, perceiving their child as simultaneously familiar and unfamiliar, resulting in grief, ambiguous loss and mourning for lost hopes, relationships and family life. This is accompanied by a psychological tsunami of emotions, including shock, guilt, fear, helplessness, shame and chronic sadness that often persists throughout the illness trajectory. These experiences could not be managed effectively by implementing naive “carer involvement” policies like those recommended in current guidelines.
Another more recent review of research concerning parent and family determinants of youth mental health highlights the bidirectional parent-child interactions which can influence treatment outcomes; and the role of “contemporary parenting challenges”. These include parents needing to manage children’s frequent digital technology use alongside adolescents’ drive for autonomy while parents are themselves overwhelmed by economic pressures, domestic violence, conflict or their own mental health problems. The review concludes that psycho-educational parenting interventions and targeted family interventions have significant potential to leverage parent-child warmth and affection, improving youth mental health through building parent resilience and negotiating intricate family dynamics.
Originating in Finland, Open Dialogue is a form of mental health treatment involving families directly in patient care and requiring all staff involved to have training in family therapy. This year, the first fully randomised trial of Open Dialogue published its findings, showing that the approach can significantly reduce inpatient hospital admissions. Evidence on other forms of family and couples therapy continues to emerge but has received much less investment to date than research on individual forms of therapy such as CBT. Family and couples therapy is also considerably more scarce in the NHS than individual treatments, in spite of growing evidence of effectiveness.
The Lampard Inquiry covers inpatient deaths in Essex between 2000 and 2023. Our study of the experiences of parents whose children were admitted to inpatient wards was undertaken during 2022. Most of the 15 participants had children admitted to adolescent wards in Essex (a few were admitted to wards in Cambridgeshire). We found that parents of children receiving inpatient psychiatric care face overwhelming distress; they fear their child may die or never recover and feel that their pain goes unrecognised by those around them. Relationships with services, professionals and partners become strained by conflict and any initial relief on admission gives way to complex feelings of grief and loss. Again, these overwhelming challenges would not have been avoided by ticking the “carer involvement” box.
Taking all this into account, the remit of the Lampard inquiry to consider how families are “engaged with and involved in decisions” does not seem likely to do justice to the complexity of family relationships in the context of inpatient mental health care. It seems to re-enact the naivety of welfare state policy and guidelines which prescribe “involvement” as though this offers an unambiguous course correction. Given the growing body of evidence pointing to the potential for family-based treatments rather than mere “involvement”, we suggest the Inquiry could consider how it might avoid replicating the naivety of the individual lens that has dominated mental health care for over a century in western welfare states including the UK. Given that population mental health continues to worsen, it would seem the individual lens is not working, with or without “carer involvement”. Mental health needs to be understood within the context (or lack) of family life, recognising the potential of family interventions that go beyond mechanistic “involvement”. While Lampard may deliver certain forms of justice if run well, it cannot lead to meaningful systemic change without recognising that UK mental healthcare has an in-built misconception of families.
About the authors: Suzanna Greally is a Clinical Psychologist working in Cambridgeshire and Peterborough NHS Foundation Trust, with research interests in child and adolescent mental health and family caregiving. Her work focuses on understanding and supporting the experiences of parents and families navigating mental health services for children and young people. Jeppe Oute is an Associate Professor at the University of Southern Denmark specialising in mental health, community psychology, and addiction research. His work examines how social, organisational, and policy factors shape mental health care, recovery, and lived experiences of mental distress.