The state of care management in learning disability and mental health services twelve years into community care

This paper reports on the organization of care management from a longitudinal study of community care for people resettled from long-stay learning disability and psychiatric hospitals. The findings from a 12-year follow-up of care management arrangements in 12 learning disability and eight mental health study site services are described. The diversity of care management arrangements found at earlier points in the evaluation remained evident. Also, many of the former ‘care in the community’ service users were excluded from mainstream care management arrangements in their localities. The difficulty of developing person-centred arrangements in learning disability and the lack of integration of the Care Programme Approach and care management were evident. The findings and observations are placed in the wider policy and practice context, with suggestions for taking care management forward nationally and locally.