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A national survey of mobile crisis services and their evaluation
J L Geller1, W H Fisher, M McDermeit
1Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655, USA.
Objective:
Although mobile crisis services have been widely accepted as an effective approach to emergency service delivery, no systematic studies have documented the prevalence or effectiveness of these services. This survey gathered national data on the use and evaluation of mobile crisis services.
Methods:
In 1993 mental health agencies in 50 states, the District of Columbia, and U.S. territories were surveyed. Repeated follow-up was done to ensure a 100 percent response.
Results:
A total of 39 states have implemented mobile crisis services, dispatching teams to a range of settings. Although respondents reported that use of mobile crisis services is associated with favorable outcomes for patients and families and with lower hospitalization rates, the survey found that few service systems collect evaluative data on the effectiveness of these services.
Conclusions:
The claims of efficacy made for mobile crisis services, which have led to their widespread dissemination, are based on little or no empirical evidence. More rigorous evaluation of new and existing modes of service delivery is needed. The need for such evaluation will increase in the climate promulgated by managed care, in which greater emphasis is placed on cost-effectiveness.