Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-25T13:47:29.575Z Has data issue: false hasContentIssue false

Care programming and service change in a psychiatric sector

Published online by Cambridge University Press:  02 January 2018

Sean Feeney*
Affiliation:
North Kent Healthcare NHS Trust and Honorary Senior Lecturer (UMDS) Swale Day Unit, Sittingbourne Memorial Hospital Bell Lane, Sittingbourne, Kent ME10 4DT
Steve Onyett
Affiliation:
South Kent Community Healthcare NHS Trust Folkestone, Kent
Kevin Lindsay
Affiliation:
Adult Mental Health Services, Invicta Community Care, Priority House, Maidstone, Kent
*
Correspondence
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The effects of service expansion and change (including Joint working with social services) following the provision of a community mental health centre and the introduction of care management were examined by auditing service activity. Data were collected on service provision to 20 randomly selected patients who met the local criteria for care management, and also on the general level of service activity as judged by service contacts for all disciplines. Compared to the baseline period, face to face contact with care-managed patients increased six-fold. There were more home contacts, a wider range of professional contacts occurred, and a greater variety of types of treatment provided. A substantial (though not statistically significant) reduction in day hospital attendance was seen over the period studied. The number of service contacts for non-care-managed patients also rose. The introduction of care management was simplified by changes in service organisation. Increased resources were needed to both implement care management and provide an adequate service to the remainder of patients. Both aspects of the service functioned efficiently in parallel.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1998 The Royal College of Psychiatrists

References

Bennett, D. (1991) The drive towards the community. In 150 Years of British Psychiatry 1841–1991 (eds Berrios, G. & Freeman, H.), pp. 321332. London: Gaskell.Google Scholar
Department of Health (1990) ‘Caring for People’ . The Care-Programme Approach for People with a Mental Illness Referred to the Specialist Psychiatric Services. Heywood: Department of Health.Google Scholar
Gournay, K. & Brooking, J. (1994) Community psychiatric nurse in primary health care. British Journal of Psychiatry, 165, 231238.Google Scholar
Isaacs, A. D. & Bebbington, P. B. (1991) Strategies for the management of severe psychotic illness in the community. International Review of Psychiatry, 3, 7182.Google Scholar
Kingdon, D. (1994) Making care programming work. Advances in Psychiatric Treatment, 1, 4146.Google Scholar
Marshall, M. (1996) Case management: a dubious practice. British Medical Journal, 312, 523524.CrossRefGoogle ScholarPubMed
Melzer, D., Hale, A., Malik, S., et al (1991) Community care for patients with schizophrenia one year after discharge. British Medical Journal, 303, 10231026.Google Scholar
Muijen, M., Marks, I., Connolly, J., et al (1992) Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749754.CrossRefGoogle ScholarPubMed
Onyett, S. (1992) Case Management in Mental Health. London: Chapman and Hall.Google Scholar
Santos, A. B., Henggeler, S. W., Burns, B. J., et al (1995) Research on field-based services: models for reform in the delivery of mental health care to populations with complex clinical problems. American Journal of Psychiatry, 152, 11111123.Google Scholar
Salokangas, R., Pala-Oja, T., Ojanen, M., et al (1991) Needs for community care among psychotic outpatients. Acta Psychiatrica Scandinavica, 84, 191196.Google Scholar
Sayce, L., Craig, T. & Boardman, A. (1991) The development of community mental health centres in the UK. Social Psychiatry and Psychiatric Epidemiology, 26, 1420.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.