Crisis intervention for people with severe mental illnesses

Area of Science:

• Mental Health
• Psychiatry
• Healthcare Management

Background:

• Community treatment of serious mental illness (SMI) faces challenges in delivering adequate care during acute phases.
• Crisis-intervention models were developed to address these challenges in mental healthcare.
• This review focuses on the effectiveness of crisis intervention for individuals with SMI during acute episodes.

Purpose of the Study:

• To review the effects of crisis-intervention models compared to standard care for individuals with SMI experiencing acute episodes.
• To compare mobile crisis teams with residential crisis units, if data allowed.

Main Methods:

• Searched the Cochrane Schizophrenia Group's Study-Based Register of Trials up to September 2014.
• Included eight randomized controlled trials (RCTs) involving 1144 participants.
• Extracted data, estimated risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI), and assessed risk of bias.

Main Results:

• Crisis intervention may reduce repeat hospital admissions (high-quality evidence).
• It appears to reduce family burden and improve mental state and global state (low to moderate quality evidence).
• Participant satisfaction was higher, but quality of life scores were similar; no differences in death rates were found.

Conclusions:

• Crisis-intervention care is a viable and acceptable treatment for SMI.
• Evidence quality for main outcomes is low to moderate, with limitations in study design (blinding, reporting, attrition).
• Further evaluative studies are needed for widespread implementation of crisis intervention.