Outcomes of crises before and after introduction of a crisis resolution team.
BACKGROUND
Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited.


OBJECTIVE
To compare outcomes of crises before and after introduction of a CRT.


METHODS
A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established.


RESULTS
Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life.


CONCLUSIONS
CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.
Johnson
Sonia
S
Department of Mental Health Sciences, Royal Free and University College London Medical Schools, Wolfson Building, 48 Riding House Street, London W1W 7EY, UK. s.johnson@ucl.ac.uk
Nolan
Fiona
F
Hoult
John
J
White
Ian R
IR
Bebbington
Paul
P
Sandor
Andrew
A
McKenzie
Nigel
N
Patel
Sejal N
SN
Pilling
Stephen
S
D000328:Adult; D001509:Bed Occupancy / Q000706:statistics & numerical data; D003156:Community Mental Health Services / Q000458:organization & administration*; D003419:Crisis Intervention / Q000458:organization & administration*; D004630:Emergencies; D005260:Female; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life