Efficacy of mental health crisis houses compared with acute mental health wards: a literature review

Abstract

Background Crisis houses are an alternative to acute psychiatric hospital admission.Aim To review evidence of the efficacy of mental health crisis houses as an alternative to acute hospital admissions.Method A systematic search of studies drawing on eight databases was undertaken, with a total of 135 articles identified. After the selection process, six quantitative and two qualitative studies met the inclusion criteria of the review. Of these, the quantitative studies were assessed for methodological quality using a 21-item tool and all studies were analysed using thematic synthesis.Findings Four of the studies were rated methodologically strong and two as methodologically moderate. It was found that people admitted to crisis houses experience fewer negative events, have more autonomy, receive more holistic care and spend more time with staff members. They also receive more peer support and report more therapeutic relationships with staff.Conclusion Service users who access crisis houses rather than acute wards tend to rate their recovery as lower and think that pharmacological treatments are less available. Crisis house admissions are shorter and less expensive than acute ward stays, but do not always prevent admission to hospital.