Care Programme Approach
{{Short description|UK community mental health services system}}
{{Use dmy dates|date=April 2022}}
Care Programme Approach (CPA) in the United Kingdom is a system of delivering community mental health services to individuals diagnosed with a mental illness. It was introduced in England in 1991Department of Health (1990). "Care Programme Approach" Circular HC(90)23/LASSL(90)11. London: Department of Health and by 1996 become a key component of the mental health system in England.Department of Health (1995). Building bridges. A guide to arrangements for interagency working for the care and protection of seriously mentally ill people. London: HMSO. The approach requires that health and social services assess need, provided a written care plan, allocate a care coordinator, and then regularly review the plan with key stakeholders,{{cite web|url=http://www.cpaa.co.uk/thecareprogrammeapproach|title=CPA association|access-date=2009-06-29|archive-url=https://web.archive.org/web/20090508123526/http://www.cpaa.co.uk/thecareprogrammeapproach|archive-date=2009-05-08|url-status=dead}} in keeping with the National Health Service and Community Care Act 1990.
History and impact
In 1999 the approach was simplified to standard and enhanced levels, the term key worker was changed to care coordinator, and there was an emphasis on risk management, employment and leisure, and the needs of the carer.{{cite web|url=http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009221 |year=1999 | author = Department of Health | title=Effective care co-ordination in mental health services: modernising the care programme approach | publisher = London: Department of Health| access-date=2009-06-29}}
There is some criticism that the approach has changed the role of staff away from implementing clinical interventions into administrative tasks,{{cite journal |author=Simpson A |title=Community psychiatric nurses and the care coordinator role: squeezed to provide 'limited nursing' |journal= Journal of Advanced Nursing|volume=52 |issue=6 |pages=689–99 |date=December 2005 |pmid=16313382 |doi=10.1111/j.1365-2648.2005.03636.x |url=http://openaccess.city.ac.uk/8074/1/Community_psychiatric_nurses_and_the_care_co-ordinator_role.pdf}}{{Cite journal |doi = 10.1136/bmj.312.7045.1540a|pmid = 8646162|pmc = 2351243|title = Administrative demands of care programme approach|journal = BMJ|volume = 312|issue = 7045|pages = 1540|year = 1996|last1 = Easton|first1 = C.|last2 = Oyebode|first2 = F.}} that the policy is carried out inconsistently,{{cite journal |vauthors=Bindman J, Beck A, Glover G |title=Evaluating mental health policy in England. Care Programme Approach and supervision registers |journal= The British Journal of Psychiatry |volume=175 |issue= 4|pages=327–30 |date=October 1999 |pmid=10789298 |doi= 10.1192/bjp.175.4.327|s2cid=25896815 |display-authors=etal}}{{cite journal |vauthors=Schneider J, Carpenter J, Brandon T |title=Operation and organisation of services for people with severe mental illness in the UK. A survey of the Care Programme Approach |journal= The British Journal of Psychiatry |volume=175 |issue= 5|pages=422–5 |date=November 1999 |pmid=10789272 |doi= 10.1192/bjp.175.5.422|s2cid=21845991 }}{{cite journal |vauthors=Venables D, Hughes J, Stewart K, Challis D |title=Variations in |journal=Care Management Journals |volume=6 |issue=3 |pages=131–8 |year=2005 |pmid=16642687 |doi= 10.1891/cmaj.6.3.131|s2cid=23000567 }} and has not been well aligned to clinical models of case management.{{cite journal |vauthors=Simpson A, Miller C, Bowers L |title=Case management models and the care programme approach: how to make the CPA effective and credible |journal= Journal of Psychiatric and Mental Health Nursing|volume=10 |issue=4 |pages=472–83 |date=August 2003 |pmid=12887640 |doi= 10.1046/j.1365-2850.2003.00640.x|url=http://openaccess.city.ac.uk/7330/1/Case_management_models_and_the_Care_Programme_Approach.pdf}} Formal review on the impact and effectiveness of this initiative has been difficult because of the variation of clinical interventions given under a CPA model.{{cite journal |author=Burns T |title=Case management, care management and care programming |journal= British Journal of Psychiatry|volume=170 |issue= 5|pages=393–5 |date=May 1997 |pmid=9307684 |doi= 10.1192/bjp.170.5.393|doi-access=free }}
= CPA in a prison setting =
A research paper by M. Georgiou and J. Jethwa discusses the purpose of the CPA model and discusses key themes in its benefits and shortcomings, in order to provide a more organized framework for care of inmates in a prison setting. The key themes are listed below.{{Cite journal|last1=Georgiou|first1=Megan|last2=Jethwa|first2=Jemini|date=2021-01-01|title=Planning effective mental healthcare in prisons: Findings from a national consultation on the Care Programme Approach in prisons|url=https://www.sciencedirect.com/science/article/pii/S1752928X20302122|journal=Journal of Forensic and Legal Medicine|language=en|volume=77|pages=102105|doi=10.1016/j.jflm.2020.102105|pmid=33370674 |s2cid=229714642 |issn=1752-928X|url-access=subscription}}
== Objectives of CPA ==
- Interagency collaboration
- Catering to the complex needs of the patient
- Ongoing care (upon release from prison)
- Patient involvement in CPA, centered around them
== Challenges faced when implementing CPA ==
- Responsibilities are not clear
- Geographically deprived for program outreach
- Patient has little or no awareness of CPA
- Lack of understanding CPA process
- Prison capacity to implement program (e.g., too many cases, not enough resources, patient dropout from CPA)
See also
References
{{reflist|2}}
External links
- [http://www.cpaa.co.uk CPA Association]
- [http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/DH_083650 DOH Making the CPA work for you]
- [https://web.archive.org/web/20090519012547/http://www.rethink.org/about_mental_illness/peoples_experiences/jesss_journey/care_programme.html Rethink CPA information]
Category:Treatment of mental disorders