Dieneke Hubbeling1, Robert Bertram. 1. Wandsworth Crisis and Home Treatment Team, Springfield Hospital, London SW17 7DJ, UK. dieneke@doctors.org.uk
Abstract
BACKGROUND: Crisis resolution and home treatment teams (CRTs) and home treatment teams have been established nationwide in the UK to reduce admissions to psychiatric hospitals. However, the evidence for CRTs was limited at the time of their introduction. AIMS: Review of the literature accumulated since the national rollout of CRTs in 2000. METHOD: Systematic narrative literature review utilising British Nursing Index, Cinahl, Embase, Medline and PsyINFO. RESULTS: The search revealed one randomised controlled trial and a number of naturalistic studies. The balance of evidence suggests that CRTs can reduce hospital beds and costs with similar symptomatic outcome and service user satisfaction, but there is no evidence that CRTs are the only way to do so. There is no conclusive evidence that CRTs cause an increase in serious and untoward incidents (SUIs) or compulsory admissions. CONCLUSIONS: Currently, there is no compelling evidence for the widespread implementation of CRTs. In the future, the incidence of compulsory admissions and SUIs needs to be studied at a national level, CRTs have to be compared with other methods to reduce hospital admissions and studies need to specify sample and treatment characteristics with greater detail.
BACKGROUND: Crisis resolution and home treatment teams (CRTs) and home treatment teams have been established nationwide in the UK to reduce admissions to psychiatric hospitals. However, the evidence for CRTs was limited at the time of their introduction. AIMS: Review of the literature accumulated since the national rollout of CRTs in 2000. METHOD: Systematic narrative literature review utilising British Nursing Index, Cinahl, Embase, Medline and PsyINFO. RESULTS: The search revealed one randomised controlled trial and a number of naturalistic studies. The balance of evidence suggests that CRTs can reduce hospital beds and costs with similar symptomatic outcome and service user satisfaction, but there is no evidence that CRTs are the only way to do so. There is no conclusive evidence that CRTs cause an increase in serious and untoward incidents (SUIs) or compulsory admissions. CONCLUSIONS: Currently, there is no compelling evidence for the widespread implementation of CRTs. In the future, the incidence of compulsory admissions and SUIs needs to be studied at a national level, CRTs have to be compared with other methods to reduce hospital admissions and studies need to specify sample and treatment characteristics with greater detail.
Authors: Dan Siskind; Meredith Harris; Steve Kisely; Victor Siskind; James Brogan; Jane Pirkis; David Crompton; Harvey Whiteford Journal: Community Ment Health J Date: 2013-10-23