The implementation of crisis resolution home treatment teams in wales: results of the national survey 2007-2008.
BACKGROUND
In mental health nursing, Crisis Resolution and Home Treatment (CRHT) services are key components of the shift from in-patient to community care. CRHT has been developed mainly in urban settings, and deployment in more rural areas has not been examined.


OBJECTIVE
We aimed to evaluate CRHT services' progress towards policy targets.


METHODS
All 18 CRHT teams in Wales were surveyed.


METHODS
A service profile questionnaire was distributed to team leaders.


RESULTS
Fourteen of 18 teams responded in full. All but one were led by nurses, who formed the main professional group. All teams reported providing an alternative to hospital admission and assisting early discharge. With one exception, teams were 'gatekeeping' hospital beds. There was some divergence in clients seen, perceived impact of the service, operational hours, distances travelled, team structure, input of consultant psychiatrists and caseloads. We found some differences between the 8 urban teams and the 6 teams serving rural or mixed areas: rural teams travelled more, had fewer inpatient beds, and less medical input (0.067 compared to 0.688 whole time equivalents).. Most respondents felt that resource constraints were limiting further developments.


CONCLUSIONS
Teams met standards for CHRT services in Wales; however, these are less onerous than those in England, particularly in relation to operational hours and staffing complement. As services develop, it will be important to ensure that rural and mixed areas receive the same level of input as urban areas.
Jones
Richard
R
Hywel Dda NHS Trust, Hafan Derwen, Parc Dewi Sant, Carmarthen, SA31 3BB, UK.
Jordan
Sue
S