Outcomes of crises before and after introduction of a crisis resolution team.

Abstract

Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited. To compare outcomes of crises before and after introduction of a CRT. A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established. Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life. CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.