Psychiatric Bulletin (2008) 32: 374-377. doi: 10.1192/pb.bp.107.018366
© 2008 The Royal College of Psychiatrists
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Implementation of crisis resolution/home treatment teams in England: national survey 2005–2006{dagger}

Steve Onyett, Senior Development Consultant/Visiting Professor

Care Services Improvement Partnership SouthWest Development Centre, Mallard Court, Express Park, Bristol Road, Bridgwater, Somerset TA6 4RN, email: steve.onyett{at}nimhesw.nhs.uk

Karen Linde, Senior Research Fellow

Institute of Public Policy, Leeds University

Gyles Glover, Consultant in Public Health

North East Public Health Observatory, and Honorary Professor of Public Mental Health, Wolfson Research Institute, University of Durham

Siobhan Floyd, Research Associate

Avon and Wiltshire Mental Health Partnership NHS Trust

Steven Bradley, IT Consultant

Department of Computer Science, University of Durham

Hugh Middleton, Associate Professor

School of Sociology & Social Policy, University of Nottingham, and Honorary Consultant Psychiatrist, Nottinghamshire Healthcare NHS Trust

Declaration of interest

Funded through the Department of Health’s Policy Research Programme.

{dagger} See original paper pp. 378–379, this issue.

AIMS AND METHOD

To describe implementation of crisis resolution/home treatment (CRHT) teams in England, examine obstacles to implementation and priorities for development. We conducted an online survey followed by a telephone or face-to-face interview among 243 teams.

RESULTS

Considerable progress has been made in implementation with a subset of teams demonstrating strong fidelity to the Department of Health’s guidance, particularly in urban settings. However, only 40% of teams described themselves as fully established. Many teams reported a high assessment load, understaffing, limited multidisciplinary input and patchy fulfilment of their gatekeeping role.

CLINICAL IMPLICATIONS

Successful implementation of the CRHT teams as alternatives to hospital admission requires resources for home treatment out of hours, effective systems working among local services, stronger local understanding and advocacy of the teams’ role.


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Crisis resolution/home treatment teams, gate-keeping and the role of the consultant psychiatrist
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