Audit of Deaf and Hearing patients’ knowledge of the Care Programme Approach in a High Secure Psychiatric Hospital

Helen Ord, Gareth Garrett, Manjit Gahir, Steven Milne


The Care Programme Approach (CPA) was developed by the UK Government in an attempt to improve the care of people with severe mental illness (DH, 1989) by having a co-ordinated, multi-disciplinary approach from service providers, relatives/carers and patients. For it to be meaningful, it is necessary that patients understand the CPA process in order that they can actively participate in it. 

The aim of this audit was to ascertain whether patients who were deaf or hard of hearing (d/Deaf) had specific difficulties with regard to understanding the CPA process. To determine this we compared a group of d/Deaf patients with a group of male, hearing patients. Both groups have a diagnosis of at least one mental disorder and are detained under the Mental Health Act 1983 in long term care at Rampton Hospital, which is a high secure hospital in Nottinghamshire, England. 

We found a significant difference in knowledge about CPA between d/Deaf and hearing patients. More effort needs to be made to improve communication with deaf patients about the CPA process.

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