Care management and the care programme approach: towards integration in old age mental health services

Objective To examine the relationship between carl management arrangements and the Care Programme Approach (CPA) in the context of old age mental heal th services and, particularly, dementia services. Method The information reported is from a national study of care management arrangements, funded by the Department of Health. A response rate of 77% w as obtained from local authority social services departments. Results in old age mental health services over half of the respondents repo rted joint screening arrangements for health and social care, almost four-f ifths reported both joint criteria for the allocation of key workers and a clear definition of monitoring responsibilities. Of the latter over two-fif ths were reported as being the same in care management and the CPA. Forty-s ix per cent of respondents provided a specialist service for people with de mentia. Three-fifths of respondents reported that they did not apply CPA to people with dementia who were in receipt of care management or did so in l ess than 20% of cases. Where the CPA was applied it was more likely that a priority would be accorded to care management. A quarter of respondents rep orted the shared use of assessment documentation for people with dementia. Discussion The findings are set in the context of service developments to d ate and the implementation of the two systems of community based coordinate d care for older people with mental health problems. Inter-authority variat ions are noted and the potential for greater service integration within the current legislative framework assessed. Copyright (C) 2001 John Wiley & So ns, Ltd.