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

Abstract

The Care Programme Approach (CPA) and supervision register policies in England are intended to prioritize patients to receive specialist mental health care. To describe and evaluate the practical application of the policies. A questionnaire survey of key informants in mental health provider trusts and an analysis of aggregated data collected by health authorities using the Mental Illness Needs Index as a measure of population need. On average, 1175 per 100,000 total population are subject to the CPA (95% CI = 1055-1309) and 8.6 per 100,000 (95% CI = 7.5-9.9) are on supervision registers. Wide local variations in the number of people subject to the CPA and supervision registers are not explained by variations in population need. Prioritization to receive specialist mental health services is carried out inconsistently, and inequitable use of resources may result.