Evaluating mental health policy in England - Care Programme Approach and supervision registers

Background The Care Programme Approach (CPA) and supervision register polic ies in England are intended to prioritise patients to receive specialist me ntal health care. Aims To describe and evaluate the practical application of the policies. Method A questionnaire survey of key informants in mental health provider t rusts and an analysis of aggregated data collected by health authorities us ing the Mental Illness Needs Index as a measure of population need. Results On average, 1175 per 100 000 total population are subject to the CP A (95% CI=1055-1309) and 8.6 per 100 000 (95% Cl=7.5-9.9) are on supervisio n registers. Wide local variations in the number of people subject to the C PA and supervision registers are not explained by variations in population need. Conclusions Prioritisation to receive specialist mental health services is carried out inconsistently, and inequitable use of resources may result. Declaration of interest The study was funded by a grant from the Department of Health.