The implementation of the Care Programme Approach for service users with a learning disability. Building Bridges to the same Old Horizons?

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Abstract

Accessible summary

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.

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