Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study

Abstract

Objective: To evaluate the effectiveness of a crisis resolution team.

Design: Randomised controlled trial.

Participants: 260 residents of the inner London Borough of Islington who were experiencing crises severe enough for hospital admission to be considered.

Interventions: Acute care including a 24 hour crisis resolution team (experimental group), compared with standard care from inpatient services and community mental health teams (control group).

Main outcome measures: Hospital admission and patients' satisfaction.

Results: Patients in the experimental group were less likely to be admitted to hospital in the eight weeks after the crisis (odds ratio 0.19, 95% confidence interval 0.11 to 0.32), though compulsory admission was not significantly reduced. A difference of 1.6 points in the mean score on the client satisfaction questionnaire (CSQ-8) was not quite significant (P = 0.07), although it became so after adjustment for baseline characteristics (P = 0.002).

Conclusion: Crisis resolution teams can reduce hospital admissions in mental health crises. They may also increase satisfaction in patients, but this was an equivocal finding.

Figure 1

Flow of participants through study