scholarly journals The care programme approach

1996 ◽  
Vol 20 (9) ◽  
pp. 550-552 ◽  
Author(s):  
J. S. Jamieson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Inner City ◽  
Serious Mental Illness ◽  
Continuing Care ◽  
Community Mental Health Team ◽  
Care Programme ◽  
Mental Health Team ◽  
Health Team ◽  
High Level

The CPA encourages good psychiatric practice in the continuing care in the community of people who suffer with serious mental illness. The tiered CPA has recently been proposed with a view to channel resources towards those patients who are most in need. This study assesses whether the CPA is used appropriately and effectively among patients discharged in an inner city sector where there is a high level of serious mental illness. The results suggest that it is feasible provided there is an adequately developed community mental health team.

scholarly journals The clinical complexity of cases of schizophrenia in a community mental health team: a 3 year comparison

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S340-S340
Author(s):  
Shay-Anne Pantall ◽  
Laxsan Karunanithy ◽  
Hayley Boden ◽  
Lisa Brownell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Community Mental Health ◽  
List Type ◽  
Community Mental Health Team ◽  
Service Usage ◽  
Care Programme ◽  
Mental Health Team ◽  
Health Team ◽  
Long Acting

AimsTo describe the changes in complexity and management of individuals with schizophrenia in a community mental health team (CMHT) over a three year period.BackgroundIt is often believed that individuals receiving care from CMHTs are those with low levels of complexity and risk, and are relatively stable, with more complex individuals being managed by assertive outreach or other specialist teams. Here, we describe changes in the complexity, comorbidity, service-usage and management, of patients with a diagnosis of schizophrenia in a CMHT between 2016 and 2019.MethodData were collected from an electronic patient record system (RiO) for all individuals with schizophrenia in a CMHT in Birmingham (n = 84 in 2016, n = 71 in 2019), examining demographic variables, comorbidity, use of mental health services and current management.ResultKey findings included: - •63% were managed through care programme approach (CPA) in 2016, compared to only 31% in 2019.•21% had required home treatment or inpatient care in the preceding 12 months in 2016; this had improved to 8.5% in 2019.•Significant levels of psychiatric comorbidity, including addictions with almost half of patients (46.5%) having a known history of substance use in 2019, compared to only 15.5% noted in 2016.•Pharmacological management has remained broadly similar; in 2016 21% patients were taking a combination of 2 antipsychotics compared to only 10% in 2019 and 25% were taking clozapine in 2016 (21% in 2019). 39% were prescribed a long acting antipsychotic injection in 2016, compared to 32% in 2019.•In 2016, medication was being prescribed in the majority of cases within secondary care (55%) patients and in primary care in only 21%. GPs have now taken on greater prescribing responsibility in 2019, prescribing in 44% of cases, with 47% being prescribed by the CMHT.ConclusionThe acuity and management of individuals with a diagnosis of schizophrenia under the care of a CMHT has changed over a 3 year period. It is positive to note the reduced use of crisis services and lower rates of polypharmacy. There is a reduction in the proportion of patients receiving management through CPA, and a move towards more medication being prescribed in primary care. The reasons for this change are however unclear and may reflect change in available resources, given that more than half of this group receive clozapine or long acting injections, and have high levels of comorbidity.

The importance of service level measures for mental health policy

1997 ◽  
Vol 6 (S1) ◽  
pp. 229-237 ◽  
Author(s):  
Rachel Jenkins ◽  
Gyles Glover
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Policy ◽  
Community Mental Health ◽  
Health Services ◽  
Mission Statement ◽  
Mental Health Policy ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

The policy of any organisation is a setting out of the purposes for which it exists - its mission statement. Governments spend money on mental health services and therefore need a coherent mission statement for the use and goals to which that money is put. Moreover, the consequences of mental illness pervade all aspects of a nation's existence. Therefore a mission statement is needed to tackle mental illness and its consequences, not only by developing and using specialist mental health services to best effect, but also by using other relevant organisations as appropriate.Mental health policy is formulated at all levels from the community mental health team to the national government and thence to the World Health Organisation and the United Nations. Indeed national and international mental health policies have generally been led by local innovative best clinical practice. At local level, the policy of a community mental health team will identify the types of patients to which it seeks to provide a service, the channels through which referrals will be accepted, the type and nature of assessment and decision making about consequent interventions which will be used and a range of quality standards within which it will seek to operate. It may set out a set of desired goals in terms of the improvement in the health status of clients and the degree of consumer satisfaction it seeks to achieve. Some adverse consequences may be set out. For example, it may seek to minimise readmissions to hospital within a specified period of time or the frequency of violent or self-destructive behaviour on behalf of its clients.

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

2001 ◽  
Vol 10 (4) ◽  
pp. 441-447 ◽  
Author(s):  
Peter L. Cornwall ◽  
Barbara Gorman ◽  
Jane Carlisle ◽  
Marie Pope
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Community Mental Health Team ◽  
Care Programme ◽  
Mental Health Team ◽  
Health Team ◽  
The Uk ◽  
The Impact

scholarly journals Fertile Imaginations: an inner city allotment group

1999 ◽  
Vol 23 (5) ◽  
pp. 291-293 ◽  
Author(s):  
Joanna Seller ◽  
Jon Fieldhouse ◽  
Michael Phelan
Keyword(s):  
Mental Illness ◽  
Inner City ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Moral Treatment ◽  
Health Team ◽  
City Community ◽  
The Past ◽  
People With Mental Illness ◽  
Kitchen Gardens

Engaging people with mental illness in horticultural activities is nothing new. Asylums encouraged patients to work on farms, in orchards and in kitchen gardens. This activity gradually became distilled, formalised and applied clinically as ‘moral treatment’, out of which occupational therapy evolved (Paterson, 1997). ‘Fertile Imaginations' is an attempt to offer horticultural activities to people with mental illness, within the framework of an inner city community mental health team (CMHT) and to ensure that the activities that engaged and benefited patients in the past, are not now denied.

scholarly journals Members of a community mental health team

1997 ◽  
Vol 21 (9) ◽  
pp. 547-549 ◽  
Author(s):  
Benjamin Lucas
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Professional Community ◽  
Community Mental Health Care ◽  
Community Mental Health Team ◽  
Mental Health Nurses ◽  
Care Programme ◽  
Mental Health Team ◽  
Health Team ◽  
Community Mental Health Nurses

The aim was to find out if professions differed in their contributions to the workload of two multi-professional community mental health teams. Both teams aimed to provide community mental health care in London, targeting those with severe mental illness and using the care programme approach. Junior psychiatrists had fewer contacts than other professionals but medical staff tended to contribute more to assessments. Community mental health nurses tended to have the most contacts. Community mental health team planners should be aware of inter-professional differences when designing teams.

scholarly journals Community mental health team management in severe mental illness: A systematic review

2001 ◽  
Vol 178 (6) ◽  
pp. 497-502 ◽  
Author(s):  
Shaeda Simmonds ◽  
Jeremy Coid ◽  
Philip Joseph ◽  
Sarah Marriott ◽  
Petertyrer
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Community Mental Health ◽  
Severe Mental Illness ◽  
Odds Ratio ◽  
Team Management ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

BackgroundCommunity mental health teams are now generally recommended for the management of severe mental illness but a comparative evaluation of their effectiveness is lacking.AimsTo assess the benefits of community mental health team management in severe mental illness.MethodA systematic review was conducted of community mental health team management compared with other standard approaches.ResultsCommunity mental health team management is associated with fewer deaths by suicide and in suspicious circumstances (odds ratio=0.32, 95% CI 0.09–1.12), less dissatisfaction with care (odds ratio=0.34, 95% CI 0.2–0.59) and fewer drop-outs (odds ratio=0.61, 95% CI 0.45–0.83). Duration of in-patient psychiatric treatment is shorter with community team management and costs of care are less, but there are no gains in clinical symptomatology or social functioning.ConclusionsCommunity mental health team management is superior to standard care in promoting greater acceptance of treatment, and may also reduce hospital admission and avoid deaths by suicide. This model of care is effective and deserves encouragement.

scholarly journals Evaluation of a client held record introduced by a community mental health team

1997 ◽  
Vol 21 (12) ◽  
pp. 757-759 ◽  
Author(s):  
Anna Stafford ◽  
Richard Laugharne
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Community Mental Health ◽  
Patient Involvement ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

A client held record for patients with long-term mental illness was introduced by a community mental health team in east London. The record was evaluated by asking the opinions of 45 patients and examining how their client record had been used. Over 80% of the patients found the record and the information it contained useful, 74% of contacts were recorded in the booklet and the client held record had begun to be used by many professionals for purposes other than appointments and medication. A client held record can increase patient involvement in care and help communication between professionals.

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