As described in Chapter 2, the development of crisis services before the late 1990s was rather piecemeal. Except for the adoption of crisis teams throughout one Australian state, most of the early developments were single model services, often widely admired but little replicated. The recent NHS modernisation in England radically reversed this picture, in that the introduction of crisis resolution teams (CRTs) became government policy. The context in which this has occurred, the function that CRTs are intended to serve in modern mental healthcare systems and the implementation of this new English policy will be described in this chapter.

The first English crisis resolution teams

From the late 1980s to the late 1990s, the cornerstone of community mental healthcare in the UK was the community mental health team (CMHT). Service planners in most English catchment areas followed the pattern established by the British community care pioneers of the 1950s and 1960s: when home visits were provided in crises, this was usually the responsibility not of a distinct crisis service but of a generic catchment area service for the mentally ill. An example of a project that sought to introduce more extensive home working within this model was the introduction and evaluation by Burns and colleagues (1993) in southwest London in the late 1980s of multidisciplinary home visits for all new referrals within two weeks of referral.