The Psychiatrist (2010) 34: 50-54. doi: 10.1192/pb.bp.108.023077
© 2010 The Royal College of Psychiatrists
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Controlled comparison of two crisis resolution and home treatment teams

P. Tyrer1

P. Tyrer is Professor of Community Psychiatry, Imperial College London

F. Gordon1

F. Gordon is Statistical Consultant, Statistical Advisory Service, Imperial College London

S. Nourmand1

S. Nourmand is Research Associate, Department of Psychological Medicine, Imperial College London

M. Lawrence2

M. Lawrence works at the Pendine Centre, Cardiff

C. Curran2

C. Curran is Consultant Psychiatrist at the Pendine Centre, Cardiff

D. Southgate3

D. Southgate works in the Psychology and Counselling Services Directorate, Whitchurch Hospital, Cardiff

B. Oruganti4

B. Oruganti works at the South Cardiff Crisis Resolution and Home Treatment Team

M. Tyler5

M. Tyler works at the Cardiff and Vale NHS Trust

S. Tottle5

S. Tottle works at the Adult Mental Health Directorate, Cardiff and Vale NHS Trust

B. North1 and E. Kulinskaya1

B. North and E. Kulinskaya are with the Statistical Advisory Service, Imperial College London

J. T. Kaleekal4

J. T. Kaleekal is with the South Cardiff Crisis Resolution Team

J. Morgan2

J. Morgan is Consultant Psychiatrist at the Pendine Centre, Cardiff.

Declaration of interest None.

1 Imperial College London

2 Pendine Centre, Cardiff

3 Whitchurch Hospital, Cardiff

4 South Cardiff Crisis Resolution and Home Treatment Team

5 Cardiff and Vale NHS Trust

Correspondence: Correspondence to Peter Tyrer (p.tyrer{at}imperial.ac.uk)

Aims and method To compare an existing crisis resolution service with a new crisis resolution team (CRT) in Wales. The impact of the new team was measured by changes in bed days and admissions. A random sample of patients from each service was assessed for service satisfaction, social functioning and quality of life after first presentation.

Results The total number of bed days was reduced following the introduction of the new CRT (27.3%). The frequency and duration of compulsory admissions increased by 31% in the CRT between the first and second years and by 7% in the control service, offset by a greater reduction in informal admissions in the CRT (23.5%) compared with the control group (13.3%); overall bed usage was unchanged. Service satisfaction, social functioning and quality of life showed no important differences between the services.

Clinical implications Crisis resolution teams may reduce informal admissions in the short term but at the cost of more compulsory admissions later.




eLetters:

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Confusing title and misleading assumptions: Controlled comparison of two Crisis resolutions and home
Prem N Mahadun, et al.
The Psychiatrist Online, 20 Feb 2010 [Full text]
Let's not throw the baby out with the bath water
Stephen Ogunremi, et al.
The Psychiatrist Online, 20 Feb 2010 [Full text]