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Crisis teams: systematic review of their effectiveness in practice

  • Rebecca A. Carpenter (a1) (a2), Jara Falkenburg (a1) (a2), Thomas P. White (a2) and Derek K. Tracy (a1) (a2)
Abstract
Aims and method

Crisis resolution and home treatment teams (variously abbreviated to CRTs, CRHTTs, HTTs) were introduced to reduce the number and duration of in-patient admissions and better manage individuals in crisis. Despite their ubiquity, their evidence base is challengeable. This systematic review explored whether CRTs: (a) affected voluntary and compulsory admissions; (b) treat particular patient groups; (c) are cost-effective; and (d) provide care patients value.

Results

Crisis resolution teams appear effective in reducing admissions, although data are mixed and other factors have also influenced this. Compulsory admissions may have increased, but evidence that CRTs are causally related is inconclusive. There are few clinical differences between ‘gate-kept’ patients admitted and those not. Crisis resolution teams are cheaper than in-patient care and, overall, patients are satisfied with CRT care.

Clinical implications

High-quality evidence for CRTs is scarce, although they appear to contribute to reducing admissions. Patient-relevant psychosocial and longitudinal outcomes are under-explored.

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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.
Corresponding author
Derek K. Tracy (derek.tracy@oxleas.nhs.uk)
Footnotes
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Declaration of interest

D.K.T. works and R.A.C. and J.F. have worked in a crisis team. The team was one of the Royal College of Psychiatrists' successful pilot sites for the new Home Treatment Accreditation Scheme (HTAS).

Footnotes
References
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Crisis teams: systematic review of their effectiveness in practice

  • Rebecca A. Carpenter (a1) (a2), Jara Falkenburg (a1) (a2), Thomas P. White (a2) and Derek K. Tracy (a1) (a2)
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