What is known on the subject?
What does this article add to existing knowledge?
What are the implications for practice?Introduction:
The Care Programme Approach was introduced in England to ensure services met the needs of people with mental health problems and a concurrent learning disability (dual diagnosis). The CPA implementation was patchy and services failed to work in partnership.Aim:
This study aimed to explore the factors shaping the recent implementation of the CPA for service users with a dual diagnosis.Method:
A single case study approach was undertaken. Data were collected through interview (n = 26), documentary analysis (n = 64), steering group observation (n = 3) and the Partnership Assessment Tool (n = 26). Data were analysed using the Framework Approach.Results:
The CPA was only effectively implemented for people who were deemed to present with a high level of risk.Discussion:
The problems associated with implementation in the 1990s continue more recently for those with a dual diagnosis. The CPA has become more aligned with risk management protocols than supporting individual service user's recovery.Implications for practice:
Service users should be involved in the implementation of policies which have an impact on their recovery. The CPA should only be applied for those who present with high-risk issues, whilst alternative user-led initiatives should be considered for other service users.