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Impact of a crisis resolution team on service costs in the UK

Paul McCrone, Reader in Health Economics

*King’s College London, PO24 Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK, email: p.mccrone{at}iop.kcl.ac.uk

Sonia Johnson, Professor of Social and Community Psychiatry

Department of Mental Health Services, Royal Free and University College London Medical Schools, University College London, and Camden and Islington Mental Health and Social CareTrust, London

Fiona Nolan, Nursing Research Fellow and Stephen Pilling, Director

Camden and Islington Mental Health and Social CareTrust, London, and Sub-Department of Clinical Health Psychology, University College London

Andrew Sandor, Consultant Psychiatrist in Substance Abuse, Harrow Drug and Alcohol Service

Central and North West London NHS Foundation Trust

John Hoult, Psychiatrist and Nigel McKenzie, Consultant Psychiatrist

Camden and Islington Mental Health and Social CareTrust, London

Ian R. White, Senior Scientist

MRC Biostatistics Unit, Cambridge

Paul Bebbington, Head of Department

Department of Mental Health Sciences, Royal Free and University College London Medical Schools, University College London, and Camden and Islington Mental Health and Social CareTrust, London, UK

Declaration of interest

None.

AIMS AND METHODS

This paper assesses the economic impact of a crisis resolution team (CRT) in South London, using data from a prospective controlled trial. Two cohorts of patients were compared. After referral with a psychiatric crisis, the first cohort received existing services and the second cohort had access to input from a CRT. Baseline and follow-up 6-month costs were measured for 181 cases.

RESULTS

At follow-up, mean costs were £1681 less for the post-CRT patients, which was not statistically significant. However, a significant difference of £2189 was observed when patients with any CRT contact were compared with those with none.

CLINICAL IMPLICATIONS

The crisis resolution team resulted in lower costs. Such services can thus help to release funds for other forms of care.