Crisis teams: Systematic review of their effectiveness in practice

TY - JOUR

T1 - Crisis teams

T2 - Systematic review of their effectiveness in practice

AU - Carpenter, Rebecca A.

AU - Falkenburg, Jara

AU - White, Thomas P.

AU - Tracy, Derek K.

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Aims and method Crisis resolution and home treatment teams (variously abbreviated to CRTs, CRHTTs, HTTs) were introduced to reduce the number and duration of in-patient admissions and better manage individuals in crisis. Despite their ubiquity, their evidence base is challengeable. This systematic review explored whether CRTs: (a) affected voluntary and compulsory admissions; (b) treat particular patient groups; (c) are cost-effective; and (d) provide care patients value. Results Crisis resolution teams appear effective in reducing admissions, although data are mixed and other factors have also influenced this. Compulsory admissions may have increased, but evidence that CRTs are causally related is inconclusive. There are few clinical differences between 'gate-kept' patients admitted and those not. Crisis resolution teams are cheaper than in-patient care and, overall, patients are satisfied with CRT care. Clinical implications High-quality evidence for CRTs is scarce, although they appear to contribute to reducing admissions. Patient-relevant psychosocial and longitudinal outcomes are under-explored.

AB - Aims and method Crisis resolution and home treatment teams (variously abbreviated to CRTs, CRHTTs, HTTs) were introduced to reduce the number and duration of in-patient admissions and better manage individuals in crisis. Despite their ubiquity, their evidence base is challengeable. This systematic review explored whether CRTs: (a) affected voluntary and compulsory admissions; (b) treat particular patient groups; (c) are cost-effective; and (d) provide care patients value. Results Crisis resolution teams appear effective in reducing admissions, although data are mixed and other factors have also influenced this. Compulsory admissions may have increased, but evidence that CRTs are causally related is inconclusive. There are few clinical differences between 'gate-kept' patients admitted and those not. Crisis resolution teams are cheaper than in-patient care and, overall, patients are satisfied with CRT care. Clinical implications High-quality evidence for CRTs is scarce, although they appear to contribute to reducing admissions. Patient-relevant psychosocial and longitudinal outcomes are under-explored.

UR - http://www.scopus.com/inward/record.url?scp=84880915054&partnerID=8YFLogxK

U2 - 10.1192/pb.bp.112.039933

DO - 10.1192/pb.bp.112.039933

M3 - Review article

AN - SCOPUS:84880915054

SN - 1758-3209

VL - 37

SP - 232

EP - 237

JO - Psychiatrist

JF - Psychiatrist

IS - 7

ER -