title: The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise.
abstract: OBJECTIVE
  To assess the effectiveness of crisis resolution/home treatment services for older people with mental health problems.
  
  
  METHODS
  A systematic review was conducted to report on the effectiveness of crisis resolution/home treatment teams (CRHTTs) for older people with mental health problems. As part of the review, we also carried out a scoping exercise to assess the typologies of older people's CRHTTs in practice, and to review these in the context of policy and research findings.
  
  
  RESULTS
  The literature contains Grade C evidence, according to the Oxford Centre of Evidence Based Medicine (CEBM) guidelines, that CRHTTs are effective in reducing numbers of admissions to hospitals. Outcomes such as length of hospital stay and maintenance of community residence were reviewed but evidence was inadequate for drawing conclusions. The scoping exercise defined three types of home treatment service model: generic home treatment teams; specialist older adults home treatment teams; and intermediate care services. These home treatment teams seemed to be effectively managing crises and reducing admissions.
  
  
  CONCLUSIONS
  This review has shown a lack of evidence for the efficacy of crisis resolution/home treatment teams in supporting older people with mental health problems to remain at home. There is clearly a need for a randomised controlled trial to establish the efficacy of crisis resolution/home treatment services for older people with mental health problems, as well as a more focussed assessment of the different home treatment service models which have developed in the UK.
authors.affiliation: Department of Mental Health Sciences, University College London, London, UK. sandeep.toot@nelft.nhs.uk
authors.forename: Sandeep
authors.initials: S
authors.lastname: Toot
authors.forename: Mike
authors.initials: M
authors.lastname: Devine
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D003156:Community Mental Health Services / Q000458:organization & administration; D003419:Crisis Intervention / Q000458:organization & administration; D004637:Emergency Services, Psychiatric / Q000458:organization & administration; D006699:Home Care Services / Q000458:organization & administration; D006760:Hospitalization / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D006113:United Kingdom