Home Treatment is a relatively new concept in adolescentpsychiatry. A shortage of beds in the UK, as well as the high cost of admission, has driven service innovation. Bedfordshire, which has no local inpatient unit, has developed a county wide Home Treatment Team to keep young people at home asmuch as possible. Engagement with service users is key to the aims of theservice. Understanding the young person in their context is vital in thisprocess.

To show that Home Treatment is clinically and cost effective. To show how engagement is achieved.

All young people presenting as high risk, or in crisis atA&E or other venues are seen by the team. An audit of estimated reductionof hospital admissions was done, combined with a naturalistic study of youngpeople’s and their families’ appreciation and understanding of the process. Anoutline of the teams understanding of engagement is given.

In-patient admissions were reduced, at considerable costsaving. Young people and their families found the service helpful, and werevery happy with the level of support.

Home Treatment is a safe and effective way of dealing withyoung people otherwise likely to need inpatient care. Engagement must includefamily or other carers, and close liaison with education and social services isessential.