Issues for the development of care pathways in mental health services.

Abstract

This paper seeks to discuss some of the issues for the development of care pathways for inpatients with schizophrenia. Managed care pathways are becoming increasingly popular for general adult conditions. Little is known about the development or application of care pathways for mental health services, and in particular, for inpatients diagnosed with schizophrenia. Action research principles were adopted to engage and develop support to examine care pathways. Participant observation and unstructured interviews were the primary methods used during this phase of the research. The paper draws on the experiences of one of the authors (AJ) and his attempt to discuss the potential development of a care pathway for in-patients with schizophrenia in one inner city locality in London. Four central issues were identified by the group; individualized care versus standardized care, generic practice and generic education. The development and application of care pathways for mental health services requires the consent and commitment from the work force. Many crucial barriers to development arose during the discussion groups and these will require further attention by prospective organizations wishing to apply care pathways to complex diagnostic groups such as schizophrenia.