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Individual care packages for people with severe mental illness: a description of their implementation in an English County

Published online by Cambridge University Press:  31 May 2013

R. Macpherson*
Affiliation:
Countywide services, 2gether Trust, Gloucester, UK
N. Hovey
Affiliation:
Audit Department, 2gether Trust, Gloucester, UK
A. Khan
Affiliation:
Community services, 2gether Trust, Gloucester, UK
G. Riley
Affiliation:
Corporate services, 2gether Trust, Gloucester, UK
K. Taralipoyina
Affiliation:
Countywide services, 2gether Trust, Gloucester, UK
*
*Address for correspondence: Dr R. Macpherson, Consultant Psychiatrist Wotton Lawn, Horton Road, Gloucester GL1 3WL, UK. (Email rob.macpherson@glos.nhs.uk)

Abstract

Background

This paper includes a brief review of the historical and policy background to a new form of supported accommodation, the Individual Care Package (ICP). This is a co-ordinated, individualised and flexible method to support people with complex mental health problems in the community.

Method

The study aimed to describe the implementation of this new form of care in Gloucestershire, England, over a 5-year period. We aimed to audit the quality of care in the packages against six care standards, derived by a project steering group. Staff working in community mental health services and staff providing ICPs were asked to report their levels of satisfaction with care provision.

Results

A total of 35 ICPs were developed, mostly relating to service users with severe mental illness. Only 60% of the community mental health team key workers were aware of the expected level of care. In many cases, service users were accessing support from day services or family alongside the ICP. Four service users were admitted, and four moved accommodation after going into ICPs. Overall, levels of care provided within ICPs tended to remain static. Trust key workers were mostly satisfied with the support provided in ICPs, but a range of concerns were expressed. ICP staff reported mostly positive views about the support that they received from statutory services, but also reported some concerns.

Conclusions

ICPs appeared to be successful in enabling a number of service users with complex difficulties to obtain and maintain tenancies in the community. There were some concerns about the quality of monitoring of the ICPs and some uncertainty about whether ICP staff would have the skills, support and training to promote recovery and increasing independence of service users. There was little evidence of service users moving on or reduction in care over time. There is a need for good inter-agency working for the successful deployment of this new form of service. There is also a need for more research, comparing ICPs with other forms of supported accommodation and considering the service user experience through qualitative research.

Type
Original Research
Copyright
Copyright © College of Psychiatrists of Ireland 2013 

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References

Chilvers, R, MacDonald, GM, Hayes, AA (2002). Supported housing for people with severe mental disorders. Cochrane database of systematic reviews, issue 3. Oxford Update Software: Oxford.CrossRefGoogle ScholarPubMed
Commander, M, Rooprai, D (2008). Survey of long stay patients in acute psychiatric wards. The Psychiatrist 32, 380383.Google Scholar
Department of Health (1990). National Health Service and Community Care Act. HMSO: London.Google Scholar
Department of Health and Social Security (1981). Care in the Community. HMSO: London.Google Scholar
Dinniss, S, Roberts, G, Hubbard, C, Hounsell, J, Webb, R (2007). User-led assessment of a recovery service using DREEM. Psychiatric Bulletin 31, 124127.CrossRefGoogle Scholar
Fakhoury, WKH, Murray, A, Shepherd, G, Priebe, S (2002). Research in supported housing. Social Psychiatry and Psychiatric Epidemiology 37, 301315.CrossRefGoogle ScholarPubMed
Johnson, S, Thornicroft, G, Stathdee, G (1996). Population-based assessment of needs for services. In Commissioning Mental Health Services (ed. G. Thornicroft and G. Strathdee), HMSO: London.Google Scholar
Killaspy, H, Harden, C, Holloway, F, King, M (2005). What do mental health rehabilitation services do and who are they for? A national survey in England. Journal of Mental Health 14, 157165.CrossRefGoogle Scholar
Lelliott, P (1996). Meeting the accommodation needs of the most severely mentally ill. Journal of Interprofessional Care 10, 241247.CrossRefGoogle Scholar
Macpherson, R, Jerrom, W (1999). Review of twenty-four hour nursed care. Advances in Psychiatric Treatment 5, 146153.CrossRefGoogle Scholar
Macpherson, R, Shepherd, G, Edwards, T (2004a). Supported accommodation for the severely mentally ill: a review. Advances in Psychiatric Treatment 10, 180188.CrossRefGoogle Scholar
Macpherson, R, Williams, K, Elliott, H (2004b). The work of the Gloucester rehabilitation hostels, 1983–1998. The Irish Journal of Psychological Medicine 21, 5355.CrossRefGoogle Scholar
Mueser, KT, Bond, GR, Drake, RE, Resnick, SG (1998). Models of community care for severe mental illness: a review of research on care management. Schizophrenia Bulletin 24, 3774.CrossRefGoogle Scholar
Shepherd, G (1998a). Social functioning and challenging behaviour. In Social Functioning and Schizophrenia (ed. K. T. Mueser and N. Tarrier), pp. 407423. Allyn Bacon: New York.Google Scholar
Strathdee, G, Jenkins, R (1996). Purchasing mental health care for primary care. In Commissioning Mental Health Services (ed. G. Thornicroft and G. Strathdee), pp. 121. HMSO: London.Google Scholar