A study of 'crisis cards' in a community psychiatric service.
OBJECTIVE
'Crisis cards' state patients' treatment details and preferences in anticipation of a later occasion when the patient might be too ill to express them directly. We assessed the feasibility of introducing 'crisis cards', or a collaborative form of them, 'joint crisis plans', into a sectorized community psychiatric service.


METHODS
All patients with a psychosis and at high risk of crisis were invited to participate. Follow-up examined patients' satisfaction and how the cards were used.


RESULTS
In total, 106 eligible patients were identified and offered a card, and 40% agreed to participate. Patients with an affective psychosis, past suicide attempts and less frequent admissions were over-represented among those who agreed to take part. Patients chose to include a wide range of information. For participants, admissions fell by 30% in the follow-up year.


CONCLUSIONS
Crisis cards serve both a 'manifest', practical function (to provide important information when the patient is too ill to do so) and a 'latent' psychological one (positive effects on the patient's attitude to self, their illness and treatment, and their relationship with the clinical team).
Sutherby
K
K
Bethlem & Maudsley NHS Trust, London, UK.
Szmukler
G I
GI
Halpern
A
A
Alexander
M
M
Thornicroft
G
G
Johnson
C
C
Wright
S
S
D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration*; D003158:Community Psychiatry; D003299:Cooperative Behavior; D003419:Crisis Intervention; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006285:Health Planning; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D006113:United Kingdom