The Care Programme Approach and the end of indefinitely renewable Leave of Absence in Scotland

Authors

  • Jacqueline Atkinson University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ
  • Helen C Garner University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ
  • W Harper Gilmour University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ
  • James A T Dyer Argyle House, 3 Lady Lawson Street, Edinburgh, EH3 9SH

DOI:

https://doi.org/10.19164/ijmhcl.v1i11.153

Abstract

Objective

To consider the relationship between the restriction of leave of absence (LOA) to 12 months, the introduction of community care orders (CCOs) and the implementation of the Care Programme Approach (CPA).

Design

Multiple methods were employed: scrutiny of Mental Welfare Commission for Scotland (MWC) records; questionnaire to consultant psychiatrists and mental health officers (MHOs) regarding attitudes; survey of psychiatrists in respect of outcomes for named patients.

Setting

Scotland

Subjects

Two hundred and sixty six patients who were affected by the changes introduced by the Mental Health (Patients in the Community) Act 1995.

Results

Information was available for 195 (73%) patients in relation to CPA. Of these 113 (58%) were included on CPA and for 63/113 (56%) (63/195 (32%)) CPA was considered to have enhanced patient care.

Where CPA was considered useful it was because it was seen as bringing people together, enhancing the patient’s role in treatment and managing difficult situations. Negative comments regarding CPA were that it was unnecessary as the patient’s needs were straightforward, it duplicated current practices or it was too bureaucratic.

Conclusions

Despite concerns expressed by professionals about the restriction to LOA and the guidance that patients should be on CPA, for only a minority of patients was CPA described as enhancing care. Questions are raised about the low use of CCOs and CPA by psychiatrists for patients who reached the new limits of LOA.

Author Biographies

Jacqueline Atkinson, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ

Public Health and Health Policy, Division of Community Based Sciences

Helen C Garner, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ

Public Health and Health Policy, Division of Community Based Sciences

W Harper Gilmour, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ

Public Health and Health Policy, Division of Community Based Sciences

James A T Dyer, Argyle House, 3 Lady Lawson Street, Edinburgh, EH3 9SH

Former Director, Mental Welfare Commission for Scotland; OBE

Downloads

Published

2014-09-04

Issue

No. 11 (2004): September

Section

Articles and Comment

License

Authors who publish with this journal agree to the following terms:

a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work