Before a discussion of the current topic can be started, it is important first to adequately define mental illness. Mental illness is defined by the Mental Health Act as a health condition which “changes a person’s thinking, feelings, or behaviour (or all three) and that causes the person distress and difficulty”. It also includes various health conditions which are defined by defects of the individual’s normal cognitive, emotional, and behavioural functions, and caused by social, genetic, and psychological factors, including infection or head trauma. Under the Care Programme Approach, these health conditions have to be adequately evaluated in the patient and a plan of care efficiently established.
The current trend chosen by the author is the Care Programme Approach. The Care Programme Approach or the CPA was first established in England for individuals with mental illnesses, referred to psychiatric professionals. This programme requires Health Authorities, in coordination with Social Services Departments, to establish specific arrangements for the care of mentally ill patients in the community setting (CPA, 2011). This programme has four main considerations or aspects: assessment, a care plan, a key worker, and regular review (CPA, 2011). Assessment basically includes the orderly processes implemented in the assessment of the health needs of the individuals admitted with specialist mental health needs; a care plan includes the plan identified in relation to health social considerations; key workers are those who coordinate the plan and delivery of patient care; and finally, standard review is the standard and scheduled evaluation processes, as well as the changes needed in the care plan. (CPA, 2011). Changes in the CPA came about in 2008, the CPA established a new approach in mental health care which described the approach used in secondary mental health care in order to assess, plan, and coordinate treatments and support needs for individuals in contact with secondary mental health services who have severe mental health issues (Department of Health, 2008a). It is considered an approach – more than a system – because the manner by which activities are carried out is as crucial as the actual activities themselves. New qualities of those who would need CPA support include those individuals: who require multi-agency support; active engagement, intense intervention; support with dual diagnosis; and those who have a higher risk for acquiring mental health issues (DoH, 2008a). This new trend abolished the two-tier system of Standard or Enhanced CPA and discarded the single-tier system. The main goals of this new trend were to eliminate or minimize bureaucracy by removing from the system those who did not have as many health needs. It also came about because the CPA used to include patients whose needs could be covered under standard care (treatment provided within secondary mental health services, for patients not requiring the support of the CPA). The new trend or provisions of the CPA established that CPA would no longer be used in order “to describe the usual system of provision of mental health services to those with more straightforward needs in secondary mental health services” (DoH, 2008a). In effect, in instances when the service user has specified needs and can contact one agency, then he must be allowed to do so and that agency would be considered responsible for him. No formal