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Working late one evening health manager Laurie Fentimen had a phone call that left a lasting impression.

I never learn. For weeks I'd known I had a deadline for the board report, but here I was, up against the clock as usual. The phone went again - I picked it up, and as the woman on the other end began talking, I realised it wasn't even for me. It was about mental health, and I haven't been responsible for that since the last reorganisation.

But something made me listen. She was obviously worried and distressed. Although the caller lived on the other side of the country, her daughter lives in our area and has mental health problems.

Because of her illness and distress the daughter couldn't quite understand the care plan that had been drawn up for her. Who was it she was meant to contact when the suicidal feelings came back? What was the decision about medication and how it should be monitored? No one was being unhelpful or inattentive but somehow the communication between the service and the family didn't seem to be working as it should.

How was a mother to support her daughter at such distance, being helpful but not interfering? She decided not to give me her daughter's name, not wishing to breach her confidentiality. I was left with the dilemma of what to do. I talked to people in the primary care group about the issues she raised. The policies on medication management and review seemed fine, care programme approach and clinical governance systems were in place. The fundamental point seemed to be about communication. It's not easy to communicate and be fully understood when the person you are talking to is distressed or ill. But is that an acceptable excuse?

In the end, there didn't seem very much we could do. Perhaps some good will come from it. Perhaps the story, although anonymous, can be used in staff training; perhaps the application of the CPA can be audited; perhaps new guidance on medication management will be produced. But it was frustrating.

We felt at least we should write back to acknowledge her concerns. But I didn't even have her name or address. Not long after, I received a card in the post from the mother, thanking me: "My phone bill says I talked for 20 minutes. Please forgive me, it's a long time."

Forgive her, for being concerned about her daughter? For reminding me why my job exists? I'm writing this several weeks later. I can't quite remember what that report was about, but I don't think I'll forget that letter.

Laurie Fentimen is assistant director of health development at Cambridgeshire Health Authority.