Effects of a crisis resolution and home treatment team on in-patient admissions

Abstract

Aims and MethodTo evaluate the effects of a crisis resolution and home-based treatment team upon in-patient admission rates. We collected data for 2 years prior and 1 year post-implementation of such a service in Leeds. The chosen time frame allowed the new service to settle in and controlled for seasonal variations.ResultsThere were 4353 admissions during the period of the study, with 3325 in the 2 years prior to the service and 1028 in the year after. Generalised linear analysis found a 37.5% reduction in monthly admissions after the introduction of the team (P < 0.0001).Clinical ImplicationsThis study shows that in everyday clinical practice crisis resolution and home treatment teams lead to a sustained reduction in in-patient admission rates.

Impact of crisis resolution and home treatment services on user experience and admission to psychiatric hospital

“…Our findings provide evidence to support most previous studies, [5][6][7][8][9][10]12,13 which demonstrated that CRHT teams reduce admission rates and reduce length of in-patient stay. Tyrer et al 11 found a non-significant reduction of 7.7% in admissions following the introduction of a CRHT in Cardiff, but they examined a control population in which they found the same reduction of 7.7% in admissions, which they acknowledge consisted of a population so dissimilar in size and socioeconomic circumstances that it was effectively incomparable with the test group.…”

“…Reduced admission rates have been demonstrated by other studies, including a large observational study of 229 of 303 teams in England. 6,7 A number of investigations have also showed reduced length of in-patient stay following introduction of CRHT. [8][9][10] Crisis resolution and home treatment teams have now been implemented throughout England and Wales.…”

“…[8][9][10] Crisis resolution and home treatment teams have now been implemented throughout England and Wales. Jethwa et al 7 performed an evaluation of the long-term effects of the introduction of CRHT in Leeds and demonstrated a significant reduction in admission rates of 37.5% in the first year. In contrast, a study by Tyrer et al 11 found only a 7.7% reduction in admissions and no significant reduction in length of in-patient stay after the introduction of CRHT in Cardiff.…”

Admission to acute mental health services after contact with crisis resolution and home treatment teams: an investigation in two large mental health-care providers

“…Several studies reported that CRTs contribute to reducing rates of acute psychiatric admissions [11][12][13][14] and shortening length of in-patient stay 11,14 . Tyrer et al 15 found a reduction in voluntary admissions following contact with CRTs, but this was offset by a greater number of involuntary admissions.…”

Crisis resolution and home treatment teams: an evolving model

“…Some positive findings can be reported. When the model is implemented with relatively high fidelity, including 24hour cover and gatekeeping, congruent evidence from national beduse data (Glover 2006), naturalistic investigations of the effects of implementing the model within catchment areas (Johnson 2005a;Jethwa 2007;Keown 2007;Barker 2011) and a randomised controlled trial (Johnson 2005b) shows that reductions in numbers of admissions occur, with accompanying falls in costs (McCrone 2009a,b). Greater satisfaction among service users has also been reported in some CRT studies (Johnson 2005a,b;Winness 2010;Barker 2011), although we know little about the views of carers regarding the current UK model.…”