The crisis resolution team within the community service system

Abstract

Though the model of home treatment presented in this book is fairly clearly defined (Chapter 6), in practice the functioning of a team will be dependent on the context in which it operates. This includes the demographic and geographical nature of the area, and also the service context – the other services available to people in a mental health crisis, to which the crisis resolution team (CRT) must relate. The relationship between the CRT and inpatient wards and casualty departments will be considered in Chapter 15, and the clinical and operational details of referral and assessment processes in Chapters 8 and 26. In this chapter, a broader perspective is taken on the way in which CRTs fit into catchment area community mental health service systems and on the problems that may arise. The need for the CRT to have multiple interfaces with other teams and parts of the service has consequences for continuity of patient care, and these consequences are discussed and some practical proposals made for dealing with them. In the initial part of the chapter, the main focus is on working with the community mental health teams (CMHTs), which take responsibility for assessments not deemed to be crises and for continuing care of most severely mentally ill service users. Some specific issues regarding other types of recently introduced functional team, particularly early intervention services and assertive outreach teams (AOT), will then be considered.