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Outcomes of crises before and after introduction of a crisis resolution team

Sonia Johnson¹, Fiona Nolan, John Hoult

¹Department of Mental Health Sciences, Royal Free and University College London Medical Schools, Wolfson Building, 48 Riding House Street, London W1W 7EY, UK. s.johnson@ucl.ac.uk

The British Journal of Psychiatry : the Journal of Mental Science

|July 5, 2005

Abstract

Background:

Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited.

Aims:

To compare outcomes of crises before and after introduction of a CRT.

Method:

A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established.

Results:

Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life.

Conclusions:

CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.

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