Making Care Programming Work
TL;DR: There is no one correct way to implement the CPA but the pressures on services are such that the fewer the changes necessary to meet the objectives of the care programme approach, the more likely are the devised systems to be effective.
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Abstract: It is hard to disagree with the principles of the care programme approach (SPCR, 1993; Kingdon, 1994) but it has been much harder to agree how to put them into practice. What should be ‘just good practice’ becomes more complex the more it is discussed by clinical teams. This is even more so where the experience and expertise of clinicians have not been made available or used by managers, who have then developed a system required by the Department of Health but not precisely defined by it. In these circumstances, inevitably some provider unit systems have become bureaucratic and overinclusive. Every unit is different and so procedures for implementation need to be shaped to best fit the needs of the users, carers and others involved locally, and the ways of working of professional staff within services. The pressures on services are such that the fewer the changes necessary to meet the objectives of the care programme approach (CPA), the more likely are the devised systems to be effective. While there is no one correct way to implement the CPA, this article may provide some useful suggestions on refining local implementation.
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Citations
Mental health, educational and social needs of young offenders in custody and in the community.
Prathiba Chitsabesan,Sue Bailey +1 more
TL;DR: Providing services for young offenders requires investment from all the agencies in prioritising their needs, and further understanding of the developmental trajectories of high-risk groups is still needed.
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'I've got a little list' (Koko: Mikado). But is it any use? Comments on the forensic aspects of 'supervision registers' for the mentally ill.
TL;DR: 'supervision registers' are placed in brief etymological and historical context and the crucial need for adequate assessment is stressed, as is the need for critical espousal of this new device.
10
Training implications of community-oriented psychiatry
TL;DR: Community psychiatry embraces a variety of definitions: it may describe the practice setting, the population served or the philosophy of illness and treatment.
10
Care programme approach: relapsing or recovering?: Revisiting... Making care programming work
David Kingdon,Shabbir Amanullah +1 more
TL;DR: The Care Program Approach (CPA) has become an accepted part of clinical practice, despite the continuing lack of strong direct evidence of its value as discussed by the authors, despite the fact that there is still a lack of evidence for its value.
References
Care programme approach: Recent government policy and legislation
TL;DR: The care programme approach has been introduced to improve the delivery of services to people with severe mental illness and minimise the risk that they lose contact with mental health services.
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The outcome of targeting community mental health services: evidence from the West Lambeth schizophrenia cohort
A S Conway,David Melzer,A S Hale +2 more
TL;DR: The policy of targeting the long term mentally ill resulted in significant increases in professional psychiatric input ot the cohort but failed to improve access to social workers or suitable accommodation and improvements in social functioning did not follow from reductions in the proportions of patients with psychotic mental states.
Interprofessional collaboration in mental health
TL;DR: There can be few areas of community and hospital care where interprofessional collaboration would seem as fundamental, yet as difficult, as in the provision of mental health care, possibly factors in this are the major changes occurring in service settings and delivery.
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