Abstract
With the development of crisis resolution/home treatment (CR/HT) teams according to the National Health Service (NHS) Plan and Policy Implementation Guidance (Department of Health, 2000), it is important to anticipate the issues involved in their collaboration with acute in-patient units. What are the implications for in-patient care (IC) of CR/HT availability? How can we realise the opportunities that full integration can offer towards an improved acute service?
Highlights
Background and recent historyBefore examining the interface, it is useful to describe some overarching themes
We can recognise that both services are affected by the changing social position of psychiatry
With the daily reality of patients receiving acute care across the continuum of crisis resolution/home treatment (CR/HT) and in-patient care (IC), the politics and the old polarised arguments became more remote, such that it was possible to forget them while focusing on the challenge of integration
Summary
It is useful to describe some overarching themes. First, there were problems with IC before the advent of CR/HT availability. On the other hand: ‘In clinical practice, CR/HT teams admit when necessary’ and ‘In-patient treatment remains a valuable and intrinsic component of acute psychiatric services, even with CR/HT availability’. Do these sets of statements reflect some cognitive dissonance, or do they all seem logical? New teams needed to reduce admissions if they were to manage acute presentations of severe mental illness at home They did need to challenge established sets of admission expectations, which in the context of intensive community support, were less compelling. With the daily reality of patients receiving acute care across the continuum of CR/HT and IC, the politics and the old polarised arguments became more remote, such that it was possible to forget them while focusing on the challenge of integration
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