title: Methodological challenges in evaluating the effectiveness of women's crisis houses compared with psychiatric wards: findings from a pilot patient preference RCT.
abstract: There are several methodological difficulties to address when evaluating acute psychiatric services. This study explored potential methods in evaluating the effectiveness of women's crisis houses compared with psychiatric wards in a pilot patient preference randomized controlled trial. Women requiring voluntary admission to a psychiatric hospital or women's crisis house were asked to enter this pilot and different options for recruitment were explored, including different recruitment sites in the pathway to admission and methods for including women without capacity. Forty-one percent (n = 42) of women entering the study agreed to be randomized and 59% (n = 61) entered patient preference arms. Only 7% of women were recruited before admission and 1 woman without capacity entered the study, despite procedures to facilitate this. Recruitment of patients with acute psychiatric crises is therefore challenging; researchers evaluating acute services should establish a consensus on how ethically and practically to recruit patients in this setting.
authors.affiliation: Department of Health Service and Population Research, Institute of Psychiatry, King's College London, United Kingdom. l.howard@iop.kcl.ac.uk
authors.forename: Louise M
authors.initials: LM
authors.lastname: Howard
authors.forename: Morven
authors.initials: M
authors.lastname: Leese
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.forename: Helen
authors.initials: H
authors.lastname: Killaspy
authors.forename: Laura
authors.initials: L
authors.lastname: Cole
authors.forename: Caroline
authors.initials: C
authors.lastname: Lawlor
authors.forename: Sonia
authors.initials: S
authors.lastname: Johnson
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000592:standards; D003419:Crisis Intervention / Q000379:methods*; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards / Q000706:statistics & numerical data*; D006798:Housing / Q000592:standards; D006801:Humans; D008131:London / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D017060:Patient Satisfaction; D018579:Patient Selection / Q000941:ethics*; D010865:Pilot Projects; D012112:Residential Facilities; D006113:United Kingdom / Q000453:epidemiology; D014932:Women's Health Services