Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems.
BMC Health Serv Res
; 21(1): 1174, 2021 Oct 29.
Article
in En
| MEDLINE
| ID: mdl-34711222
ABSTRACT
BACKGROUND:
Inpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment at home; acute day units; and residential crisis services in the community) have recently been augmented by several new service models. These are intended to enhance choice and flexibility within catchment area acute care systems, but remain largely undocumented in the research literature. We therefore aimed to describe the types and distribution of crisis care models across England through a national survey.METHODS:
We carried out comprehensive mapping of crisis resolution teams (CRTs) using previous surveys, websites and multiple official data sources. Managers of CRTs were invited to participate as key informants who were familiar with the provision and organisation of crisis care services within their catchment area. The survey could be completed online or via telephone interview with a researcher, and elicited details about types of crisis care delivered in the local catchment area.RESULTS:
We mapped a total of 200 adult CRTs and completed the survey with 184 (92%). Of the 200 mapped adult CRTs, there was a local (i.e., within the adult CRT catchment area) children and young persons CRT for 84 (42%), and an older adults CRT for 73 (37%). While all but one health region in England provided CRTs for working age adults, there was high variability regarding provision of all other community crisis service models and system configurations. Crisis cafes, street triage teams and separate crisis assessment services have all proliferated since a similar survey in 2016, while provision of acute day units has reduced.CONCLUSIONS:
The composition of catchment area crisis systems varies greatly across England and popularity of models seems unrelated to strength of evidence. A group of emerging crisis care models with varying functions within service systems are increasingly prevalent they have potential to offer greater choice and flexibility in managing crises, but an evidence base regarding impact on service user experiences and outcomes is yet to be established.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Mental Disorders
/
Mental Health Services
Type of study:
Diagnostic_studies
Limits:
Aged
/
Child
/
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
BMC Health Serv Res
Journal subject:
PESQUISA EM SERVICOS DE SAUDE
Year:
2021
Document type:
Article
Affiliation country: