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Crisis resolution/home treatment teams and psychiatric admission rates in England

North East Public Health Observatory, Wolfson Research Institute, Stockton-on-Tees

GERDA ARTS, PhD

Department of Mathematical Science, University of Durham

KANNAN SURESH BABU, MBBS, MRCPsych

Crisis Assessment and Home Treatment Service, North Tyneside and Northumberland Mental Health Services NHS Trust, Newcastle upon Tyne, UK

Correspondence: Professor Gyles Glover, North East Public Health Observatory, Wolfson Research Institute, University Boulevard, Stockton-on-Tees TS17 6BH, UK. Email: Gyles.Glover{at}gmail.com

Declaration of interest None. Funding detailed in Acknowledgements.

Background 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 teamsin England.

Aims To examine whether national implementation of these teams was associated with comparable reductionsin admissions.

Method Observational study using routine data covering working age adult patientsin 229 of the 303 local health areasin England from 1998/9 to 2003/4.

Results 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 teamsin 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.

Conclusions Introduction of crisis resolution teams has been associated with reductions in admissions.

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