Simon Tobitt1, Sunjeev Kamboj. 1. Westways Resource Centre, South London and Maudsley NHS Foundation Trust, 49 St James's Road, Croydon, CR0 2UR, UK. Simon.Tobitt@slam.nhs.uk
Abstract
BACKGROUND: The crisis resolution/home treatment (CR/HT) model has brought significant reform of acute mental health care in the UK and beyond. The complex issue of conceptualising crisis is, however, overlooked in CR/HT literature. This study aimed to investigate how crisis is understood amongst those working in CR/HT teams. METHOD: Framework analysis was applied to semi-structured interviews with 39 CR/HT workers representative of multidisciplinary mix and drawn from four different teams. RESULTS: Whilst there was an acknowledgment of the concept's complex nature, there was consensus in: respondents' characterising of crisis; about three different presenting clinical patterns ('clusters') encountered in CR/HT work; and, the pattern of the crisis phenomenon over time. CONCLUSIONS: The findings suggest further development of the CR/HT model, including improving conceptual clarity (to benefit communication with referrers and judge clinical outcome), better timed intervention, and varying intervention for different clusters of crisis presentation.
BACKGROUND: The crisis resolution/home treatment (CR/HT) model has brought significant reform of acute mental health care in the UK and beyond. The complex issue of conceptualising crisis is, however, overlooked in CR/HT literature. This study aimed to investigate how crisis is understood amongst those working in CR/HT teams. METHOD: Framework analysis was applied to semi-structured interviews with 39 CR/HT workers representative of multidisciplinary mix and drawn from four different teams. RESULTS: Whilst there was an acknowledgment of the concept's complex nature, there was consensus in: respondents' characterising of crisis; about three different presenting clinical patterns ('clusters') encountered in CR/HT work; and, the pattern of the crisis phenomenon over time. CONCLUSIONS: The findings suggest further development of the CR/HT model, including improving conceptual clarity (to benefit communication with referrers and judge clinical outcome), better timed intervention, and varying intervention for different clusters of crisis presentation.
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