Defining the planning process

In Chapter 10 we outlined two ways of describing mental health services which are located in a particular area: the segmental approach (which considers separately each service component, treatment facility or programme) and the system approach which underlines the contribution that each programme gives to the wider system of care at the local level, and which explicitly considers the inter-relationships between the different services. We have also stressed the point that the selection of one of these two approaches for describing services is closely related to the actual organisation of services in each particular site being described.

In this chapter we shall deal with the planning of mental health services, defined in Table 13.1, using both the evidence and the ethical bases which have been discussed in the previous two chapters. It is often difficult to know whether values or evidence should be given first consideration. Here we propose to reverse the usual order (which is first evidence and later, maybe,ethics!),for the simple reason that even the choice of which evidence is to be collected and used is influenced by value judgements.We address planning for general adult services at the local level, and for simplicity we refer mainly to planning which is limited by a fixed resource input, and the task then becomes one of considering alternative ways in which to shape services for the best outcomes.We recognise that resource inputs may also vary, both to increase or decrease the total resources available.