Distinctive features of South-Verona CPS

The features of the South-Verona mental health service that could be considered "distinctive" to the service are as follows:

a. It is not experimental; the South-Verona initiative is a long-term undertaking, implemented by legislation in 1978 and based on a National Act flexible enough to permit development of a system of care which is suited to local needs;

b. It was designed and is still functioning to substitute, not to supplement, the old hospital-based system of care. The front doors of the mental hospital have been closed to new admissions since May 1978 and to all admissions since January 1982;

c. The clinical model developed in South-Verona is "systemic" and with a "single-staff module": all staff apart from nurses work both in the hospital and in the community and remain responsible for the care of the same patients across different components of the service and through the different phases of care. The "single staff" module is designed to ensure continuity of care and to encourage commitment and the assumption of full responsibility by the service.

d. The South-Verona CPS is well integrated, and allows easy and informal access to patients. It is a public service run by the National Health Service. Payment is not required, except for a fee for out-patient visits (this applies only to more affluent patients and for those who are not considered long-term).

e. Every effort is made to meet user's needs with individual care plans. A well established clinical practice in South-Verona is the critical examination of the user's explicit requests, in order to recognise what his/her real needs are. Included in this process is the need to question who originated the request for intervention (the real, often disguised or secret client), besides the usual assessment of psychosocial, precipitating and intervening factors.

f. Although not designed as an experiment, the South-Verona initiative was from the beginning associated with a long-term research project for monitoring and evaluating the changes in service organisation. The research has included, since 1994, evaluations of needs, costs and outcomes. Epidemiological data have been collected for the same year (1992), on all five levels of the Goldberg and Huxley model (general population, general practice total morbidity, general practice conspicuous morbidity, totality of psychiatric services, psychiatric hospitals and wards).