Treatment and outcomes of crisis resolution teams: a prospective multicentre study

BMC Psychiatry

Research Article

Sonia Johnson¹  Rolf W Gråwe²  Nina Hasselberg³  Torleif Ruud³ 

[1] Department of Mental Health Sciences, University College London, London, UK;Department of Research and Development at the Alcohol and Drug Treatment Health Trust in Central Norway, Trondheim, Norway;Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Research and Development at the Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;

关键词: Mental Health Service;    Mental Health System;    Treatment Episode;    Home Treatment;    Assertive Community Treatment Team;   

DOI  :  10.1186/1471-244X-11-183

 received in 2011-07-06, accepted in 2011-11-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundCrisis resolution teams (CRTs) aim to help patients in acute mental health crises without admitting them to hospital. The aims of this study were to investigate content of treatment, service practice, and outcomes of crises of CRTs in Norway.MethodsThe study had a multicentre prospective design, examining routine data for 680 patients and 62 staff members of eight CRTs. The clinical staff collected data on the demographic, clinical, and content of treatment variables. The service practices of the staff were assessed on the Community Program Practice Scale. Information on each CRT was recorded by the team leaders. The outcomes of crises were measured by the changes in Global Assessment of Functioning scale scores and the total scores on the Health of the Nation Outcome Scales between admission and discharge. Regression analysis was used to predict favourable outcomes.ResultsThe mean length of treatment was 19 days for the total sample (N = 680) and 29 days for the 455 patients with more than one consultation; 7.4% of the patients had had more than twice-weekly consultations with any member of the clinical staff of the CRTs. A doctor or psychologist participated in 55.5% of the treatment episodes. The CRTs collaborated with other mental health services in 71.5% of cases and with families/networks in 51.5% of cases. The overall outcomes of the crises were positive, with a small to medium effect size. Patients with depression received the longest treatments and showed most improvement of crisis. Patients with psychotic symptoms and substance abuse problems received the shortest treatments, showed least improvement, and were most often referred to other parts of the mental health services. Length of treatment, being male and single, and a team focus on out-of-office contact were predictors of favourable outcomes of crises in the adjusted model.ConclusionsOur study indicates that, compared with the UK, the Norwegian CRTs provided less intensive and less out-of-office care. The Norwegian CRTs worked more with depression and suicidal crises than with psychoses. To be an alternative to hospital admission, the Norwegian CRTs need to intensify their treatment and meet more patients outside the office.

【 授权许可】

CC BY   
© Hasselberg et al; licensee BioMed Central Ltd. 2011