Integration and targeting of community care for people with severe and enduring mental health problems: Users' experiences of the care programme approach and care management

Research output: Contribution to journalReview article



  • John Carpenter
  • Justine Schneider
  • Faye McNiven
  • Toby Brandon
  • Richard Stevens
  • David Wooff

External departments

  • Durham University
  • University of Kent


Original languageEnglish
Pages (from-to)313-333
Number of pages21
JournalBritish Journal of Social Work
Issue number3
Publication statusPublished - 1 Mar 2004
Publication type

Research output: Contribution to journalReview article


We report the experiences of different models of community care of random samples of 262 people with severe and enduring mental health problems living in four districts in the north of England. The districts were characterized in terms of the extent of (1) integration between the health service-led Care Programme Approach (CPA) and social services Care Management, and (2) targeting of services on people with severe mental health problems. The majority of service users felt involved in planning their own care and considered that they had choice in their care and treatment when in the community, but not in hospital. Although all these users were formally subject to the CPA, the proportions of users in the districts believing they had a written care programme ranged between 37 per cent and 60 per cent. Of these, the great majority were very positive about their care programmes and felt that they were being helped to become independent. These results were replicated when 87 per cent of the original sample was re-interviewed six months later. There were significant differences between the four districts and evidence that users preferred an integrated health and social care service. In addition, a higher proportion of users in inclusive districts were satisfied compared to those in targeted districts. Notwithstanding these positive findings, there is still considerable room for improvement in relation to the involvement of family carers and the provision of adequate information about prescribed medication and making formal complaints.