Ten years in the life of a community mental health team: The impact of the care programme approach in the UK

Abstract

Background: The aim of the study was to evaluate the changes in the operation of a community mental health service five years after the implementation of the Care Programme Approach. Method: We undertook cross-sectional surveys in 1992, before the introductions of the CPA, and in 1998, to describe the case mix and service provided. The service is entirely community-based and attempts to reduce the use of in-patient facilities by early intervention, assertive outreach and partial hospitalisation. Results: The number of patients in contact with the service increased from 293 to 334 with an increased proportion with severe mental disorder (psychotic and mood disorders) but hospitalisation did not increase. Full multidisciplinary CPA was used for patients with severe disorders and low levels of functioning. Conclusion: Introduction of clinical case management through the care programme approach was associated with an increasing focus on patients with the most severe disorders.