Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T04:04:05.400Z Has data issue: false hasContentIssue false

[No Title]

Published online by Cambridge University Press:  02 January 2018

Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
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.
Copyright
Copyright © Royal College of Psychiatrists, 2011

The increase in compulsory treatment following introduction of a crisis resolution service as observed by Forbes et al Reference Forbes, Cash and Lawrie1 was to be entirely expected as other studies have mentioned this association before. Reference Keown, Tacchi, Niemiec and Hughes2,Reference Tyrer, Gordon, Nourmand, Lawrence, Curran and Southgate3 However, I am a bit puzzled about the explanation the authors provided regarding this finding - the team probably having a low threshold for accepting risk and being more likely to consider the use of the Mental Health Act. I certainly do not believe this to be an explanation that would ring true with other crisis teams, for I am under the impression that the staff in most crisis teams have a very high threshold for admitting someone; this is, I think, to do with their role of gatekeeping admissions (and controlling the beds).

The other important aspect that needs to be considered here relates to the fact that the team in the study do not have control over admissions under the Mental Health Act outside working hours, which are between 8 am and 12 pm. It would be useful to see the numbers of people admitted under the Act out of hours, who were being assessed by other professionals undertaking their own risk assessments. It should also be remembered that many patients assessed and admitted under the Mental Health Act during working hours are not always assessed by the crisis team; community mental health teams undertake their own Mental Health Act assessments.

Finally, let us consider the staffing levels within the crisis team: one part-time staff grade psychiatrist but no dedicated consultant. This in itself may explain the fact that the team has to rely heavily upon others to undertake assessments. Once professionals outside the crisis team make a decision to detain someone there is nothing that the crisis team can do about it; they simply have to find a bed for the detained person.

References

1 Forbes, NF, Cash, HT, Lawrie, SM. Intensive home treatment, admission rates and use of mental health legislation. Psychiatrist 2010; 34: 522–4.CrossRefGoogle Scholar
2 Keown, P, Tacchi, MJ, Niemiec, S, Hughes, J. Changes to mental healthcare for working age adults: impact of a crisis team and an assertive outreach team. Psychiatr Bull 2007; 31: 288–92.CrossRefGoogle Scholar
3 Tyrer, P, Gordon, F, Nourmand, S, Lawrence, M, Curran, C, Southgate, D, et al. Controlled comparison of two crisis resolution and home treatment teams. Psychiatrist 2010; 34: 50–4.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.