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Implementation of crisis resolution/home treatment teams in England: national survey 2005–2006

  • Steve Onyett (a1), Karen Linde (a2), Gyles Glover (a3), Siobhan Floyd (a4), Steven Bradley (a5) and Hugh Middleton (a6)...
Abstract
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 gate-keeping 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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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Dean, C., Phillips, J., Gadd, E., et al (1993) Comparison of a community-based service with a hospital-based service for people with acute, severe psychiatric illness. BMJ, 307, 473476.
Department of Health (2000) The NHS Plan. HMSO.
Department of Health (2002) Mental Health Policy Implementation Guide: Community Mental Health Teams. Department of Health.
Glover, G., Arts, G. & Babu, K. S. (2006) Crisis resolution/home treatment teams and psychiatric admission rates in England. British Journal of Psychiatry, 189, 441445.
Glover, G. & Johnson, S. (2008) The crisis resolution team model: recent developments and dissemination. In Crisis Resolution and Home Treatment in Mental Health (eds Johnson, S., Needle, J., Bindman, J. P., et al). Cambridge University Press.
Johnson, S., Nolan, F., Hoult, J., et al (2005) Outcomes of crisis before and after introduction of a crisis resolution team. British Journal of Psychiatry, 187, 6875.
Joy, C. B., Adams, C. E. & Rice, K. (2006) Crisis intervention for people with severe mental illnesses. Cochrane Database of Systematic Reviews, 4, CD001087.
Middleton, H., Glover, G., Onyett, S., et al (2008) Crisis resolution/home treatment teams, gate-keeping and the role of the consultant psychiatrist. Psychiatric Bulletin, 32, 378383.
Minghella, E. (1998) Home-based emergency treatment. Mental Health Practice, 2, 1014.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Implementation of crisis resolution/home treatment teams in England: national survey 2005–2006

  • Steve Onyett (a1), Karen Linde (a2), Gyles Glover (a3), Siobhan Floyd (a4), Steven Bradley (a5) and Hugh Middleton (a6)...
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