The care programme approach: Interprofessional perspectives on mental health aftercare

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Abstract
The Care Programme Approach (CPA) is intended to provide a framework for good practice in mental health aftercare, based on keyworking. This paper offers an evaluation of the CPA and the role of mental health social work, drawing on the literature and the views of a sample of keyworkers from four different professions. It was found that practitioners view keyworking as a meaningful and comprehensible role offering professional autonomy backed by interprofessional team work, enabling them to provide a high level of support to clients. Disadvantages of the CPA were increased paperwork and threats to civil liberties. Differences between disciplines were few, all four describing a shared orientation to community support and collaborative teamwork, but it was found that nurses have taken on the new role in greatest numbers. Social workers were least integrated within multi-disciplinary teams and experienced most conflict between keyworking and other roles, hampering them in multi-disciplinary teamwork. The paper highlights problems in integrating the CPA with care management, resource implications, and a shift in policy towards greater social control of mentally ill people. It argues that the CPA is proving a useful structure for delivering care, but that social work has been marginalised due to organisational fragmentation.