An exploration of the factors influencing the local implementation of the Care Programme Approach in the provision of mental health services for clients with learning disabilities

Background The Care Programme Approach (CPA) was introduced in 1990 by the Department of Health as an approach to provide care to people with mental health problems in secondary mental health services. It aimed to improve partnership working across health and social services. However CPA faced problems from early on in its introduction to front-line services. These issues were not confronted and the policy frequently struggled at the implementation stage. -- Although never clearly indicated, clients with learning disabilities and concurrent mental health problems were meant to have their care provided through CPA. (For the purpose of this study the term ’dual diagnosis’ is used to refer to this client group). However as they were under the care of social services they were managed through care management models instead. More recently policy statements have made it clear that these clients should have their care provided through CPA. Meanwhile, CPA has become established practice in mental health care and care management has become the standard model of care in learning disability services. Service providers are now expected to work in partnership to integrate these entrenched modes of care delivery into a single approach, namely CPA. -- Study aim This study aimed to explore the factors shaping the local implementation of the adoption of the Care Programme Approach for clients with a dual diagnosis from a meso-level perspective. -- Methods The study was carried out using a case-study approach in a Mental Health NHS Foundation Trust which was working across five separate localities to implement CPA. A total of 26 semi-structured interviews were carried out with key stakeholders and members of local Steering Groups responsible for CPA implementation across the five localities. Documentary analysis of relevant Trust documents and Steering Group minutes was also undertaken.

Name dc:type.qualificationname

Doctor of Philosophy

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

King's College London

Year dc:date.issued

2012

Author dc:creator

• Kelly, Michael

Advisors dc:contributor.advisor

• Humphrey, Charlotte Miranda
• Murray, Susan Fairley
• Young, Ruth Marion

Language dc:language

eng

Identifier

oai:kclpure.kcl.ac.uk:studenttheses/0c55ba07-c7cd-4f4c-bcb1-57a28c203a80

OAI identifier oai:identifier

oai:kclpure.kcl.ac.uk:studenttheses/0c55ba07-c7cd-4f4c-bcb1-57a28c203a80