A comprehensive assessment of the nature of a crisis needs to include not only the individual's mental state but also their domestic circumstances and social network. A key outcome of this assessment is determining who is suitable for home treatment. This chapter is in two parts. In the first, John Hoult provides clinical guidance on the process of taking and accepting referrals, information gathering and the issues most important for initial decision making. In the second, Mary-Anne Cotton then reviews the literature on the factors relevant to determining suitability for home treatment.

Taking and accepting referrals

Who is suitable for referral to a crisis resolution team?

In England, the Mental Health Policy Implementation Guide for the 335 CRTs set up by the Department of Health (2001) states (p. 11) that the services should be for those ‘with severe mental illness (e.g. schizophrenia, bipolar affective disorder and severe depressive disorders) with an acute psychiatric crisis of such severity that without the involvement of a CRT hospitalization would be necessary’. While we agree that this group of patients is the main focus of crisis resolution teams (CRTs), the list of individuals for whom the guidelines say the service is not appropriate is too extensive. People with an exclusive diagnosis of personality disorder do get into acute crisis and often do get admitted to hospital; however, CRTs can usually prevent this with brief intervention.