350 Care Programme Approach

In the late 1980s, a number of serious public incidents took place when individuals with severe mental health problems assaulted and sometimes killed members of the public. These were widely reported – perhaps the most well-known of these related to the death of Jonathon Zito, who was killed by Christopher Clunis – and there were highly-publicised calls for mental health services to work more effectively to try to avoid such situations.

Close investigations of these cases revealed a number of common issues and themes:
Communication across agencies was poor
Risk assessment was weak and inconsistent
Health and social care services did not work effectively together to support people with complex mental health problems.
There was often no single professional who was co-ordinating the assessment process and the subsequent delivery of care, or monitoring and reviewing the effectiveness of interventions.

Research demonstrating the relatively high levels of psychosis among those who were homeless and in the criminal justice system also reinforced the need for improvement in the organisation and delivery of services.