Case registers for mentally handicapped people.

This thesis is an evaluation of mental handicap registers as planning tools and is based on a national postal survey and semi-structured interviews with register-operators. Registers have emerged from pressure for greater rationality in planning the health and social services, a co-ordinated approach to priority groups, and a radical change in attitude to mental handicap. Mental handicap registers are found to be organisationally, financially and morally feasible. Moreover they can develop naturally as by-products of Community Mental Handicap Teams, thereby significantly reducing the costs of data-collection. Registers provide a basis for service-planning which is more objective and takes account of more of the users of the service than the opinions of experienced professionals. Names, addresses, dates of birth and details of services used can make a considerable contribution to planning. In addition, some indicator of the services that subjects need is required. Register-operators tend to regard the widely-used Wessex Behaviour Rating System as a crude measure and hanker after a more direct assessment of need such as might be made at a multi-disciplinary review. Most registers hold identifying and service-details of their subjects; however there are a number of registers holding in addition a large amount of information for which there is little demand in planning. The data which registers have held have not been fully exploited partly because they have not been sufficiently closely linked to the planning process and the methods of planning have not been sufficiently receptive to quantitative data. Other statistical client-based data-bases for service-planning run the risk of similar neglect by decision-makers unless vigorous efforts are made to promote their use.