Crisis resolution and intensive home treatment teams

Abstract

The rise to prominence of the crisis resolution team (CRT) has been one of the most conspicuous recent changes in the English mental health care system. In the 1990s, community assessment and intervention in psychiatric emergencies was mainly the province of sectorized community mental health teams – specialized crisis services were rare. But by March 2004 at least one CRT was operating in 72% of England's primary care trust catchment areas. The rapid dissemination of this model follows the NHS Plan's requirement that CRTs should be introduced throughout England. The main aim of CRTs is to reduce need for acute psychiatric beds. To this end, they have a number of functions: to assess all patients being considered for emergency admission; to initiate intensive home treatment for every patient for whom this seems a feasible alternative to hospital; to continue home treatment until the crisis has resolved and then transfer patients to other services for any further care they may need; to reduce length of stay through early discharge from hospital to intensive home treatment whenever feasible. Groups representing service users have welcomed them, and they have the potential considerably to extend the choices available to patients and clinicians in the management of emergencies.