Some Characteristics of Long Term Clients KPP ………………. Dave King
They usually need continuous medication for their mental health condition. They may experience sporadic bouts of acute ill health or crises involving hospitalisation or some alternative treatment. Many clients also have social problems that may or may not be a consequence of their mental health condition.

Lack of occupation, poverty, poor housing and social isolation may bring the client in contact with several social agencies and mental health services (drug and alcohol, forensic etc). Personal solutions are needed because the mix of health and social factors differs for every individual and at different times in a person's life. Diagnosis is too general a to indicate common solutions appropriate to all with the same illness classification. For example, someone with Schizophrenia will have a different range of needs if the partner and occupation that has sustained their life become removed for some reason. Every person is different and same person has different needs at different times. They have grown accustomed to seeking assistance from secondary mental health services and so it seems simpler, at this stage, to regard them as 'long term clients' rather than any other description.

It may be that about 1% of the adult population use services on a long-term basis. From a variety of sources it appears that around half this number is in active contact with secondary care services at any time. Relatively few consumers are in continuous contact with services. Long term clients are usually well known to clinicians and within the group is the number may not be large the demands a relatively few individuals make on services can, at times, be considerable.

Effective health and social rehabilitation can improve the quality of their lives. Cure is rare but improvement is possible for those with conditions once thought to be chronically intractable. Clients can make recovery and learn how to reduce the bad effects of crises. Conversely, clients' health can deteriorate. Poorly organised mental health services can contribute to this.

Room for improvement
Clients and their families complain of mental health services -
- that focus on acute care and crisis resolution. and only respond in extreme crisis rather than recognising and averting known problems;
- where the client meets different medical teams and key workers every time and the frustration of being treated as a 'new case' on each occasion;
- that are fragmented with the client passed from one to another or treated simultaneously by two or more and having to attempt to co-ordinate services that may not communicate well with each other, falling into the gaps between services;
- that do not maintain a long-term relationship. Clients complain of being discharged when it is known their problems will recur. There is also concern when clients who do not maintain contact are not actively followed-up by Community Teams to ensure their treatment is continued.

Not being recognised as a frequent user can be unhelpful and harmful for long-term clients.

The Public complains of clients who are clearly in need but who have lost contact with services and help arrives only when matters have reached the stage of calling the police.