The history of the Care Programme approach in England: where did it go wrong?
Background: The Care Programme Approach (CPA) was introduced in England in 1991 as a form of case management to improve community care for people with severe mental illness. It helped services maintain contact with users but failed to provide comprehensive, co-ordinated care and is associated with i...
| Publicado en: | Journal of Mental Health Vol. 12; no. 5; pp. 489 - 505 |
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| Autores principales: | , , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Oct2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106737120&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106737120 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09638237 JHM jtl: Journal of Mental Health issn: 09638237 maglogo: N pubinfo: dt: Oct2003 vid: 12 iid: 5 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 106737120 106737120 2004077746 10.1080/09638230310001603555 106737120 ppf: 489 ppct: 16 formats: fmt: @attributes: type: P tig: atl: The history of the Care Programme approach in England: where did it go wrong? aug: au: Simpson A Miller C Bowers L affil: St Bartholomew School of Nursing, Dept of Mental Health and Learning Disability, City University, Philpot St, London E1 2EA, UK; A.Simpson@city.ac.uk sug: subj: Case Management Community Mental Health Services History Health Policy Evaluation Mental Disorders, Chronic Psychiatric Care Methods Treatment Failure Attitude of Health Personnel Change Management Consumer Satisfaction England Health Care Reform Multidisciplinary Care Team Organizational Structure Politics Teamwork ab: Background: The Care Programme Approach (CPA) was introduced in England in 1991 as a form of case management to improve community care for people with severe mental illness. It helped services maintain contact with users but failed to provide comprehensive, co-ordinated care and is associated with increased bed useAim: To describe and evaluate the introduction, implementation and development of the CPA and identify reasons for its relative failure.Method: A critical review of key events, audits, reports, research and policies that shaped the CPA.Results: Reasons for the relative failure of the CPA included the socio-political and financial context, clinicians' resistance to political and managerial interference, and the bureaucratic, complex and time-consuming nature of the policy. This reduced face-to-face contact whilst contributing to an emergent 'blame culture' and defensive psychiatric practice. The CPA also presumed levels of community resources and interprofessional teamwork that were frequently absentConclusions: The CPA was a flawed policy introduced insensitively into an inhospitable environment. It was destined to fail and after more than a decade remains ineffectively implemented. Changes introduced recently may have contradictory influences on the ability of services to provide effective case management but remain to be evaluated. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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