A crisis team for the mentally ill: the effect on patients, relatives and admissions.

A Crisis Team staffed by eight psychiatric nurses provided a 24-hour service to the seriously and chronically mentally ill who were experiencing psychiatric crisis. Immediate and continuing help was provided to patients and their relatives in their homes. Effects on patients, relatives and hospital admissions were studied. The sample consisted of 69 patients seen during a three-month study period. Six months later, 80% of patients and 73% of their relatives were interviewed by an independent psychologist. Of the sample, 80% had previous psychiatric admissions and were diagnosed as suffering from one of the functional psychoses--mainly schizophrenia or manic depression. The crises that led to the Team's interventions were mostly psychotic episodes and aggressive or suicidal behaviours; 47% occurred at night. Hospital records confirmed reports from staff, patients and relatives that the Team had halved admissions. Most patients and relatives were "very satisfied" with the treatment received from the Team and considered it had helped "greatly". They especially liked the home visits, the 24-hour availability and the friendly staff who provided them with support, medication and where needed, accommodation. In spite of the interventions of the Team, some 40% of patients were admitted during the research period, and at follow-up most were still experiencing symptoms and difficulties. Relatives, more than patients, expressed a need for additional rehabilitation and easier access to hospital, especially for those severely ill patients whom they found too difficult to live with. While the work of the Crisis Team proved highly beneficial for both patients and relatives, and reduced hospital admissions by half during the study period, it is clear that there is still a need for long-term support and rehabilitation.