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Psychiatric Bulletin (2007) 31: 288-292. doi: 10.1192/pb.bp.106.012054
© 2007 The Royal College of Psychiatrists
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Changes to mental healthcare for working age adults: impact of a crisis team and an assertive outreach team

Patrick Keown, Consultant Psychiatrist

East SCMHT, 45 Scrogg Road, Walker, Newcastle upon Tyne, NE6 4EY, email: Patrick.keown{at}nmht.nhs.uk

Mary Jane Tacchi, Consultant Psychiatrist

Crisis and Assessment Team, Ravenswood Clinic, Newcastle upon Tyne

Stephen Niemiec, Mental Health Nursing Advisor

Office of Chief Nurse, Mental Health Branch, Queensland Health Building, Brisbane, Australia

John Hughes, Consultant Psychiatrist

Crisis and Assessment Team, Ravenswood Clinic, Newcastle upon Tyne

Declaration of interest

None.

AIMS AND METHOD

To investigate changes to admissions, compulsory detentions, diagnosis, length of stay and suicides following introduction of crisis resolution home treatment and assertive out-reach teams.

RESULTS

There was a 45% reduction in admissions, with an increase in the median length of stay from 15.5 to 25 days. Bed occupancy fell by 22%. The number of suicides remained constant. Detentions under sections 2 and 3 of the Mental Health Act 1983 increased whereas those under sections 5(2) and 5(4) declined.

CLINICAL IMPLICATIONS

The introduction of crisis and assertive outreach teams was followed by a reduction in admissions, particularly short admissions. The impact differed according to gender (reduction in female bed occupancy). This and the increased length of stay need to be considered when determining the number of acute psychiatric beds needed.






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Copyright © 2007 The Royal College of Psychiatrists.