The Care Program Approach AND ITS OWN Impact Social Work Essay

This article will outline and analyse the Care and attention Programme Procedure (CPA), a public policy which was introduced in Britain in 1991. it'll critically analyse and assess how and why this insurance policy (CPA) was introduced. In doing this, it will attempt to explore the sociable problems with which the policy was worried, its ideological roots, its aims and its own nature. Finally, this essay will assess the effects of the implementation of the CPA based on issues of gain access to and final result.

What is interpersonal policy?

According to 1 website I've consulted: The name 'interpersonal policy' is utilized to apply to the policies which governments use for welfare and communal cover; to the ways in which welfare is developed in a world, also to the academic review of the topic. In the first sense, social policy is particularly concerned with cultural services and the welfare point out. In the second, broader sense, it stands for a variety of issues extending far beyond the activities of federal - the means where welfare is marketed, and the cultural and economical conditions which shape the development of welfare.

http://www2. rgu. ac. uk/publicpolicy/benefits/socpolf. htm

Social problems with which the plan (CPA) was concerned

There are several interpersonal problems with that your CPA was worried and some of them are: The 1984 murder of cultural staff member Isabel Schwarz with a ex - mental health client as cited by Sharkey (2000) prompted a federal government inquiry that was led by Sir Roy Griffiths in 1988. His report "Community Treatment: Agenda for Action" was the forerunner to the Country wide Health Service and Community Care and attention Take action of 1990 (NHSCCA) which packages out the building blocks for present day Care Programme Way in Great britain. The care programme procedure was also instigated by the Christopher Clunis' unmet needs as noted by the Ritchie Statement in 1999. The survey criticised the demeaning failures of medical and interpersonal services to work together with regards to the needs of folks with mental health problems and to protect the public. The introduction of advocates teams such as MIND, the Mental Health Foundation and Informal Carers' pressure group in the 1980s were also major sociable factors that led to the introduction of the CPA (Morris (1993). Those communities raise fundamental civil liberty issues adjoining the legal rights of people delivered back into the community from psychiatric clinic and the need for appropriate services. Another major matter corresponding to Means and Smith (1998: p48) was "the official article on Ely Clinic, Cardiff, which validated personnel cruelty to patients as of this mental handicap clinic. " They argued that "The level of media publicity produced by these happenings became so high a insurance plan response became unavoidable (ibid)".

CPA's ideological origins

There are several factors that damaged the development and establishment of the Care and attention Programme Methodology (CPA). However, the main element factors that influence the execution of the CPA are: political, economic and public. From the earliest stages of the Poor Laws through to present cultural security system, politics factors have influenced welfare provision. Like most other insurance policies, the CPA emerge consequently of the conservatism New Right ideology of bare minimum state treatment, privatisation, the idea of justice and the emergence of global market forces. The conservative federal lead by Margaret Thatcher from 1979 to the 1990s presumed, politically, in minimizing the power of the local authority and municipality with the notion that "care in the community must increasingly mean care by the city (Lavalette and Pratt 1998: 237)". Mrs Thatcher indicated the view that the sacrifices that your family and voluntary organizations have played out in community care from the Victorian age to provide day should not be viewed as second best or degrading. Her viewpoint was built on the value of mixed market, choice and given electric power back to the users of services. Mrs Thatcher was politically concerned with the political set ups of the local labour federal government and the need to give more capacity to the market pushes (private sector) to energize the economy.

The care program approach plan was also partly motivated by monetary factors. THE BRAND NEW Political Right regards the free market as the simplest way forwards for organising population. They believed that a competitive market and a combined current economic climate of welfare is vital in encouraging competition which inspires invention and efficiency that may inescapable provide better and cheaper services than a nationalised and bureaucratised services. This was a move away from the accepted orthodoxy of the Keynesian economics which sees government treatment in the provision of cultural care as necessary for the steadiness of the economy. The mixed market is therefore seen by the brand new Right as not only promoting equality and choice but also cost effective. Many thought that the politics underlying concept of presenting service users choice would cover up the huge shelling out for the uncoordinated health insurance and social care budget. As a result, both health insurance and social care services were pressured to create financial and management systems with regards to the purchase of good care. For example, communal workers became health care managers and the purchasers as opposed to the providers of care and attention.

Regarding communal ideology notion, the major social ideology was that, people with mental health problems, were expected to be integrated back into the city with clear and set up care strategies. The fatal problems by dangerous psychologically sick people such as Christopher Clunis's who was misdiagnosed and prematurely discharged then finished up getting rid of an innocent person, were major cultural factors which damaged the introduction of the CPA. The case of Clunis lifted significant cultural issues of the risk and hazard posed by people with mental health problems, especially those not getting proper care. The situation also boosts major trans-cultural interpersonal issues with regards to the great number of dark-colored men located on supervision register.

The aim of the policy

The Care Program Approach was released in order to give a clear platform for the care and attention of people with mental health issues outside hospital (Means and Smith1998: p156)", which Thompson et al (2000:573) said this include: "Systemic multidisciplinary examination, planning, monitoring, and looking at a health care plan, the addition of users and carers in the formulation and delivering of attention and identification of any lead person or key staff member" and this, "all this is undertaken within the platform that is adaptable and responsive to the client's changing needs (ibid)".

Nature of the CPA

According to Thompson et al (2000) the CPA was unveiled in 1991 and is intended to be the cornerstone of the government's mental health insurance policy. This process applies to all people that are experiencing severe mental health problems who are clients of mental health services, whether on an informal or formal basis. The coverage outlined four levels which should be used to all clients in all instances. The First stage is, to handle an assessment based on the circumstances of your client, including any support needed by carers. Second of all, to work out the care bundle in arrangement with your client, carers and relevant agencies that are designed to meet the identify need within available resources. The 3rd level is to put into practice and keep an eye on the agreed program by the appointment of an integral staff member now known as "care co-ordinator". The care co-ordinator is in charge of the analysis and planning process. He or she is actually a mental health nurse, social employee or occupational therapist. The final stage is, to examine the final results of the good care plan and if necessary undertake revision of services provided.

The policy is based on person-centred approach and the one that has been very important to health and sociable care to build up integrated plans and procedures around types of assessment, diagnostic evaluation, integrated working connections around care strategies and monitoring people in care and attention and community by means of integrated finances. Whereas, practice under earlier systems were not person-centred instead, they involved offering people limited variety of inflexible choices which were pretty much organised to meet requirements of companies rather than the service users and their carers. With mental health positioned in psychiatrist private hospitals or prisons these residents are controlled and manipulated by those in control.

The effects of the CPA

The plan helped services maintain contact with service users, stressed the need for service users participation in decision making; means that there exists coordination and communication between all the experts that are involved in the analysis and delivery of the patient's health care needs, but didn't provide thorough co-ordinated health care. This lead to many criticism been made about the insurance policy for example, it has been criticised that working mutually often causes role insecurity and role ambiguity, thus creating a significant hindrance to working mutually. The policy has also been criticised for largely being used for inpatients rather than people in the community. This was referenced by Sharkey (2000) as an important point citing the Christopher Clunis' circumstance because of the failure to offer culturally sensitive services to meet his needs and citing the exemplory case of Lavallette and Pratt (1998: 104) in which they commented that " mental health guidelines and practice based upon white Western, middle-class norms of behavior can cause something which will not understand that people from other cultural backgrounds may point out symptoms of mental health or ill health in different ways". This is useful in enabling the knowledge of how Christopher Clunis was failed by all the experts who observed him. For instance, Sharkey (2000: p83) refer to the Ritchie Record that "A GP whom Clunis possessed visited had struck him off his list because he was abusive and threatening".

The Mental Health Basis carried out a recent studies which aim was for respondents to talk openly about their mental health issues in relation to employment. They sent out about 3, 000 questionnaire and the ones who replied, 86% were white UK, 3% Dark African Caribbean, 2% Dark-colored Asian and 4% were other Western white including Irish. The particular findings shows is that ethnic minority are uneasy to speak about their mental health problems for concern with discrimination and oppression. In addition they highlighted 85% of those with permanent severe mental health problems are unemployed. These can donate to the stress and nervousness experienced by users, carers, friends and young families. For example, living with someone with serious ongoing mental health issues can cause increased pressure, worries and stress together with loss of friends and interpersonal contracts (example personal relationships), public isolation (due to stigma fastened) and issues in coping with particular symptoms. At the same time, the protection of the general public from the risk of harm is of paramount importance because patients discharged without adequate supervision or the provision necessary to meet their property, social and health needs would increase risk to themselves and people of the general public as evident regarding Christopher Clunis. The CPA has also been criticised as an insurance plan that it's largely dominated by medical module of treatment and sociable issues are neglected by practitioners and this has been highlighted by Thompson (2009) that spirituality is vital component of someone's well-being and not surprisingly concern, people's religious needs are often seen to be neglected during treatment or in developing and managing attention plans for day-to-day activities. In some instances, as known by rethink. org, a charity campaigning for mental health consciousness, spirituality is even seen as a manifestation of the individuals' psychosis or delusions by some associates of society. Despite the fact that the insurance plan was presented so that folks with severe mental health issues could be evaluated and assigned a care coordinator so they don't really present a risk to themselves or the public, there have been some issues with users of services "slipping through the web" and finding yourself either homeless or causing ham to themselves or others (sometimes even committing fatal attacks). For instance, Taylor (2010) had written on the Metro Newspapers about a man with mental medical condition who hadn't been offered treatment on several tries ended up getting rid of a pregnant female.


Even though this insurance policy has helped people with severe mental health issues to be included well into the community and live supported or independent lives, some people with mental health problems are still seen by the plan makers as a burden and stigmatised as a danger to the community. They are regularly being refused the human privileges of freedom of movements, family life, and equivalent access to paid careers and enough financial support which may then lead to homelessness and readmission in institutional care.

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