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Care Resolution Teams: how are they performing?
- Authors:
- LLOYD-EVANS Brynmor, JOHNSON Fiona
- Journal article citation:
- Mental Health Today, May/June 2014, pp.18-19.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Care Resolution Teams (CRTs) are now an established part of mental health services, but their performance across the country varies. Looks at the work of a research programme, the CORE Study, funded by the Department of Health's |National Institute for Health Research (NIHR), which aims to review and gather evidence about how CRT services function most effectively to help people in mental health crisis as possible (Edited publisher abstract)
Crisis resolution/home treatment teams, gate-keeping and the role of the consultant psychiatrist
- Authors:
- MIDDLETON Hugh, et al
- Journal article citation:
- Psychiatric Bulletin, 32(10), October 2008, pp.378-379.
- Publisher:
- Royal College of Psychiatrists
The working relationship between consultant psychiatrists and crisis resolution/home treatment (CRHT) teams varies quite widely. Data from the national survey have been used to investigate the effects of consultant psychiatrist input upon functions of the CRHT team. Logistic regression was employed to consider the effects of team size, team maturity and consultant input upon gate-keeping and fidelity to model (how many of six criteria teams’ activities included).There were statistically significant effects of size and maturity upon fidelity, and of maturity and consultant input upon gate-keeping. The relationship between the consultant psychiatrist and other elements of the acute care pathway is an important determinant of how it functions. Depending upon how they relate to them, consultants can assist or hinder a team’s capacity to fulfil their intended purposes.
Crisis resolution and home treatment: a practical guide
- Editors:
- MCGLYNN Patrick, (ed.)
- Publisher:
- Sainsbury Centre for Mental Health
- Publication year:
- 2006
- Pagination:
- 80p., bibliog.
- Place of publication:
- London
The Government target of 335 crisis resolution and home treatment (CRHT) teams in the UK has been met. But not all are meeting targets for reducing admissions to acute psychiatric inpatient care. This new guide looks at the core characteristics of effective teams and examines how they can manage risk positively, work in partnership with service users and carers, and facilitate early discharge from hospital. It provides an invaluable resource for all those who are interested in the future development of CRHT teams.
Implementation of crisis resolution/home treatment teams in England: national survey 2005–2006
- Authors:
- ONYETT Steve, et al
- Journal article citation:
- Psychiatric Bulletin, 32(10), October 2008, pp.374-377.
- Publisher:
- Royal College of Psychiatrists
Describes the implementation of crisis resolution/home treatment (CRHT) teams in England, examine obstacles to implementation and priorities for development. The authors conducted an online survey followed by a telephone or face-to-face interview among 243 teams. Considerable progress has been made in implementation with a subset of teams demonstrating strong fidelity to the Department of Health’s guidance, particularly in urban settings. However, only 40% of teams described themselves as fully established. Many teams reported a high assessment load, understaffing, limited multidisciplinary input and patchy fulfilment of their gatekeeping role. Successful implementation of the CRHT teams as alternatives to hospital admission requires resources for home treatment out of hours, effective systems working among local services, stronger local understanding and advocacy of the teams’ role.
Crisis resolution and home treatment teams for older people with mental illness
- Authors:
- DIBBEN Claire, et al
- Journal article citation:
- Psychiatric Bulletin, 32(7), July 2008, pp.268-270.
- Publisher:
- Royal College of Psychiatrists
Examined the impact of a crisis resolution and home treatment teams (CRHTT) on hospital admission rates, bed days and treatment satisfaction among older people with mental illness and their carers. The authors compared these factors in the 6 months before the service started and 6 months after its introduction. The CRHTT significantly reduced admissions, but there was no significant difference in the length of hospital stay as compared before and after the introduction of this service. There was a trend towards carers, but not patients, being more satisfied with treatment after the introduction of the CRHTT. Admissions for older people were up by 31% and carers preferred the service. Further research on crisis teams in older people with mental illness is needed using randomised controlled methodology.
Home but not alone
- Author:
- JACKSON Catherine
- Journal article citation:
- Mental Health Today, November 2007, pp.16-17.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article looks at how intensive home treatment can help reduce hospital admissions. It draws on the experience of NHS Forth Valley and its intensive home treatment team (IHTT), based in Falkirk. IHTT differs from the community mental health teams (CMHTs) in that its role is specifically to deliver a short-term, intensive care package to very ill people referred by GPs and other community services who would otherwise be treated in hospital.
Crisis resolution/home treatment teams and psychiatric admission rates in England
- Authors:
- GLOVER Gyles, ARTS Gerda, BABU Kannan Suresh
- Journal article citation:
- British Journal of Psychiatry, 189(5), November 2006, pp.441-445.
- Publisher:
- Cambridge University Press
Introduction of crisis resolution/home treatment teams has been associated with a reduction in hospital admissions in trials. Between 2001 and 2004 there was a rapid expansion in the numbers of these teams in England. The aim was to examine whether national implementation of these teams was associated with comparable reductions in admissions. Observational study using routine data covering working age adult patients in 229 of the 303 local health areas in England from 1998/9 to 2003/4. Admissions fell generally throughout the period, particularly for younger working age adults. Introduction of crisis resolution teams was associated with greater reductions for older working age women (35–64 years); teams always on call were associated with additional reductions for older men and younger women. By the end of the study admissions had fallen by 10% more in the 34 areas with crisis resolution teams in place since 2001, and by 23% more in the 12 of these on call around the clock than in the 130 areas without such teams by 2003/4. Reductions in bed use were smaller. Introduction of assertive outreach teams was not associated with overall reductions in admissions. Introduction of crisis resolution teams has been associated with reductions in admissions.
Initial treatment phase in early psychosis: can intensive home treatment prevent admission?
- Authors:
- GOULD Matthew, et al
- Journal article citation:
- Psychiatric Bulletin, 30(7), July 2006, pp.243-246.
- Publisher:
- Royal College of Psychiatrists
The aim of this study was to describe the early treatment phase in first-episode psychosis in an area with well-established crisis resolution teams. Socio-demographic characteristics and patterns of initial treatment were investigated for all individuals with first-episode psychosis identified prospectively over a 1-year period in two London boroughs. Over a year, 111 people presented with first-episode psychosis. Fifty-one people (46%) were initially managed in the community, with the remaining 60 (54%) admitted to in-patient units immediately. By 3 months after presentation, a total of 80 people (72%) had been admitted and 54 (49%) had been compulsorily detained under the Mental Health Act 1983. Thirty-three people were initially managed by the crisis resolution teams and 15 of these were eventually admitted. In a catchment area in which alternatives to admission are well developed, the admission rate for first-episode psychosis was still high.
Home chemotherapy for children with cancer: perspectives from health care professionals
- Authors:
- STEVENS Bonnie, et al
- Journal article citation:
- Health and Social Care in the Community, 12(2), March 2004, pp.142-149.
- Publisher:
- Wiley
The goal of this study was to determine the perspectives of healthcare professionals (HPs) from community and hospital settings involved in a paediatric home chemotherapy programme. Using a prospective descriptive study design, HPs including paediatricians, community nurses, hospital clinic nurses, administrators and pharmacists were interviewed using a moderately structured open-ended approach. Through inductive content analysis, data were categorised under 3 themes reflecting HPs' perspectives on the programme: perceived family benefits, human resources and service delivery considerations and impact on the HP's role. All HPs reported that home chemotherapy helped reduce both disruption to family life and psychological stress. Community-based HPs reported increased job satisfaction, increased workload and increased frustration related to scheduling challenges. Hospital-based HPs reported decreased patient interaction and discrepancies in workload changes. Both groups emphasised the need for consistency in care and for specific chemotherapy training. Service delivery issues included the need for more clarity in the programme process, improved eligibility criteria, a focus on community laboratory coordination and development of centralised communications.
Use of naltrexone for the treatment of opiate addiction in Campania, Italy: the role of family
- Authors:
- LOFFREDA Anna, et al
- Journal article citation:
- Journal of Substance Use, 8(3), September 2003, pp.182-185.
- Publisher:
- Taylor and Francis
In Italy, naltrexone for the treatment of opioid dependence is frequently administered to opiate-dependent patients sent for treatment via special treatment facilities, the Public Services for Treatment of Drug Addition (SERT). In the region Campania, prescription data showed that the use of naltrexone outside SERT is higher compared to the other regions of Italy. This study was carried out in order to identify factors that influence the higher utilization of naltrexone outside SERT in Campania. Three-hundred and fifty patients followed by 13 SERTs have been evaluated. Twenty per cent of patients withdrew from the trial in the very first months. At the beginning of the study, 63% of the patients received naltrexone at SERT, while 37% were treated at home with the support of their families. Later during treatment, the majority of patients were treated at home. Families showed a high degree of participation and cooperation in the rehabilitation of patients (75%). These data suggest that the support of families was especially important for motivation of retention treatment and integration with psychosocial programmes. Naltrexone treatment can be continued at home after a short period of treatment from the public service if families intensively participate in the therapeutic programme.