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Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems

BACKGROUND: Inpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment a...

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Autores principales: Dalton-Locke, Christian, Johnson, Sonia, Harju-Seppänen, Jasmine, Lyons, Natasha, Sheridan Rains, Luke, Stuart, Ruth, Campbell, Amelia, Clark, Jeremy, Clifford, Aisling, Courtney, Laura, Dare, Ceri, Kathleen, Kelly, Lynch, Chris, McCrone, Paul, Nairi, Shilpa, Newbigging, Karen, Nyikavaranda, Patrick, Osborn, David, Persaud, Karen, Stefan, Martin, Lloyd-Evans, Brynmor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553397/
https://www.ncbi.nlm.nih.gov/pubmed/34711222
http://dx.doi.org/10.1186/s12913-021-07181-x
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author Dalton-Locke, Christian
Johnson, Sonia
Harju-Seppänen, Jasmine
Lyons, Natasha
Sheridan Rains, Luke
Stuart, Ruth
Campbell, Amelia
Clark, Jeremy
Clifford, Aisling
Courtney, Laura
Dare, Ceri
Kathleen, Kelly
Lynch, Chris
McCrone, Paul
Nairi, Shilpa
Newbigging, Karen
Nyikavaranda, Patrick
Osborn, David
Persaud, Karen
Stefan, Martin
Lloyd-Evans, Brynmor
author_facet Dalton-Locke, Christian
Johnson, Sonia
Harju-Seppänen, Jasmine
Lyons, Natasha
Sheridan Rains, Luke
Stuart, Ruth
Campbell, Amelia
Clark, Jeremy
Clifford, Aisling
Courtney, Laura
Dare, Ceri
Kathleen, Kelly
Lynch, Chris
McCrone, Paul
Nairi, Shilpa
Newbigging, Karen
Nyikavaranda, Patrick
Osborn, David
Persaud, Karen
Stefan, Martin
Lloyd-Evans, Brynmor
author_sort Dalton-Locke, Christian
collection PubMed
description BACKGROUND: Inpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment at home; acute day units; and residential crisis services in the community) have recently been augmented by several new service models. These are intended to enhance choice and flexibility within catchment area acute care systems, but remain largely undocumented in the research literature. We therefore aimed to describe the types and distribution of crisis care models across England through a national survey. METHODS: We carried out comprehensive mapping of crisis resolution teams (CRTs) using previous surveys, websites and multiple official data sources. Managers of CRTs were invited to participate as key informants who were familiar with the provision and organisation of crisis care services within their catchment area. The survey could be completed online or via telephone interview with a researcher, and elicited details about types of crisis care delivered in the local catchment area. RESULTS: We mapped a total of 200 adult CRTs and completed the survey with 184 (92%). Of the 200 mapped adult CRTs, there was a local (i.e., within the adult CRT catchment area) children and young persons CRT for 84 (42%), and an older adults CRT for 73 (37%). While all but one health region in England provided CRTs for working age adults, there was high variability regarding provision of all other community crisis service models and system configurations. Crisis cafes, street triage teams and separate crisis assessment services have all proliferated since a similar survey in 2016, while provision of acute day units has reduced. CONCLUSIONS: The composition of catchment area crisis systems varies greatly across England and popularity of models seems unrelated to strength of evidence. A group of emerging crisis care models with varying functions within service systems are increasingly prevalent: they have potential to offer greater choice and flexibility in managing crises, but an evidence base regarding impact on service user experiences and outcomes is yet to be established. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07181-x.
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spelling pubmed-85533972021-10-29 Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems Dalton-Locke, Christian Johnson, Sonia Harju-Seppänen, Jasmine Lyons, Natasha Sheridan Rains, Luke Stuart, Ruth Campbell, Amelia Clark, Jeremy Clifford, Aisling Courtney, Laura Dare, Ceri Kathleen, Kelly Lynch, Chris McCrone, Paul Nairi, Shilpa Newbigging, Karen Nyikavaranda, Patrick Osborn, David Persaud, Karen Stefan, Martin Lloyd-Evans, Brynmor BMC Health Serv Res Research BACKGROUND: Inpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment at home; acute day units; and residential crisis services in the community) have recently been augmented by several new service models. These are intended to enhance choice and flexibility within catchment area acute care systems, but remain largely undocumented in the research literature. We therefore aimed to describe the types and distribution of crisis care models across England through a national survey. METHODS: We carried out comprehensive mapping of crisis resolution teams (CRTs) using previous surveys, websites and multiple official data sources. Managers of CRTs were invited to participate as key informants who were familiar with the provision and organisation of crisis care services within their catchment area. The survey could be completed online or via telephone interview with a researcher, and elicited details about types of crisis care delivered in the local catchment area. RESULTS: We mapped a total of 200 adult CRTs and completed the survey with 184 (92%). Of the 200 mapped adult CRTs, there was a local (i.e., within the adult CRT catchment area) children and young persons CRT for 84 (42%), and an older adults CRT for 73 (37%). While all but one health region in England provided CRTs for working age adults, there was high variability regarding provision of all other community crisis service models and system configurations. Crisis cafes, street triage teams and separate crisis assessment services have all proliferated since a similar survey in 2016, while provision of acute day units has reduced. CONCLUSIONS: The composition of catchment area crisis systems varies greatly across England and popularity of models seems unrelated to strength of evidence. A group of emerging crisis care models with varying functions within service systems are increasingly prevalent: they have potential to offer greater choice and flexibility in managing crises, but an evidence base regarding impact on service user experiences and outcomes is yet to be established. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07181-x. BioMed Central 2021-10-29 /pmc/articles/PMC8553397/ /pubmed/34711222 http://dx.doi.org/10.1186/s12913-021-07181-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Dalton-Locke, Christian
Johnson, Sonia
Harju-Seppänen, Jasmine
Lyons, Natasha
Sheridan Rains, Luke
Stuart, Ruth
Campbell, Amelia
Clark, Jeremy
Clifford, Aisling
Courtney, Laura
Dare, Ceri
Kathleen, Kelly
Lynch, Chris
McCrone, Paul
Nairi, Shilpa
Newbigging, Karen
Nyikavaranda, Patrick
Osborn, David
Persaud, Karen
Stefan, Martin
Lloyd-Evans, Brynmor
Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title_full Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title_fullStr Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title_full_unstemmed Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title_short Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems
title_sort emerging models and trends in mental health crisis care in england: a national investigation of crisis care systems
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553397/
https://www.ncbi.nlm.nih.gov/pubmed/34711222
http://dx.doi.org/10.1186/s12913-021-07181-x
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