People diagnosed with schizophrenia need new care schemes, says tsar

An influential inquiry will recommended that every person
diagnosed with schizophrenia should be subject to an enhanced
multidisciplinary care programme designed to prevent suicide and
homicide, Community Care can exclusively reveal.

The National Confidential Inquiry into suicide and homicide by
people with mental illness, chaired by mental health tsar Louis
Appleby, is to launch its recommendations at the end of the
week.

The report reveals wide variations in the use of the enhanced
Care Programme Approach (CPA) to ensure ongoing care for people
with severe mental health problems.

The report found that half of suicides and a third of homicides
by people in recent contact with mental health services were
committed by those who were subject to enhanced CPA. A significant
proportion of those who committed suicide were not complying with
treatment or had missed their last appointment. And a quarter of
people with schizophrenia who committed suicide, and half of those
who had killed someone else, had not been placed on enhanced
CPA.

The inquiry recommends a “major overhaul” of the enhanced Care
Programme Approach, with the development of clear national criteria
for its use. It calls for people with schizophrenia to be
automatically placed on enhanced CPA, while people with severe
mental illness and a history of self-harm or violence, or who are
homeless or are lone parents, should also be routinely subject to
it.

The inquiry’s recommendations have met with a mixed response.
Margaret Edwards, head of strategy at mental health group Sane,
said it was “shocking that for nearly half of those who committed
suicide, the CPA was not providing the protection for which it was
designed”.

David Joannides, Association of Directors of Social Services
spokesperson on mental health, said it was probably unrealistic to
suggest that all people with schizophrenia should be on enhanced
CPA.