Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;69(4):928-941.
doi: 10.1177/00207640221142530. Epub 2022 Dec 16.

Service use preceding and following first referral for psychiatric emergency care at a short-stay crisis unit: A cohort study across three cities and one rural area in England

Lucy Pollyanna Goldsmith  1 , Katie Anderson  2 , Geraldine Clarke  3 , Chloe Crowe  4 , Heather Jarman  1   5 , Sonia Johnson  6 , Jo Lomani  7 , David McDaid  8 , A-La Park  8 , Jared G Smith  1 , Steven Gillard  9
Affiliations

Service use preceding and following first referral for psychiatric emergency care at a short-stay crisis unit: A cohort study across three cities and one rural area in England

Lucy Pollyanna Goldsmith et al. Int J Soc Psychiatry. 2023 Jun.

Abstract

Background: Internationally, hospital-based short-stay crisis units have been introduced to provide a safe space for stabilisation and further assessment for those in psychiatric crisis. The units typically aim to reduce inpatient admissions and psychiatric presentations to emergency departments.

Aims: To assess changes to service use following a service user's first visit to a unit, characterise the population accessing these units and examine equality of access to the units.

Methods: A prospective cohort study design (ISCTRN registered; 53431343) compared service use for the 9 months preceding and following a first visit to a short-stay crisis unit at three cities and one rural area in England. Included individuals first visited a unit in the 6 months between 01/September/2020 and 28/February/2021.

Results: The prospective cohort included 1189 individuals aged 36 years on average, significantly younger (by 5-13 years) than the population of local service users (<.001). Seventy percent were White British and most were without a psychiatric diagnosis (55%-82% across sites). The emergency department provided the largest single source of referrals to the unit (42%), followed by the Crisis and Home Treatment Team (20%). The use of most mental health services, including all types of admission and community mental health services was increased post discharge. Social-distancing measures due to the COVID-19 pandemic were in place for slightly over 50% of the follow-up period. Comparison to a pre-COVID cohort of 934 individuals suggested that the pandemic had no effect on the majority of service use variables.

Conclusions: Short-stay crisis units are typically accessed by a young population, including those who previously were unknown to mental health services, who proceed to access a broader range of mental health services following discharge.

Keywords: Mental health crisis; emergency department; experience of care; mental health nursing; psychiatric admission; short-stay crisis care.

PubMed Disclaimer

Conflict of interest statement

None.

References

    1. Anderson K., Goldsmith L., Lomani J., Ali Z., Clarke G., Crowe C., Jarman H., Johnson S., McDaid D. (2022). Short-stay crisis units for mental health service users on crisis care pathways: Systematic review and meta-analysis. BJPsych Open, 8(4), E144. https://doi.org/doi:10.1192/bjo.2022.534 - PMC - PubMed
    1. Bhui K., Stansfeld S., Hull S., Priebe S., Mole F., Feder G. (2003). Ethnic variations in pathways to and use of specialist mental health services in the UK: Systematic review. British Journal of Psychiatry, 182(2), 105–116. 10.1192/bjp.182.2.105 - DOI - PubMed
    1. Braitberg G., Gerdtz M., Harding S., Pincus S., Thompson M., Knott J. (2018). Behavioural assessment unit improves outcomes for patients with complex psychosocial needs. Emergency Medicine Australasia, 30(3), 353–358. - PubMed
    1. Browne V., Knott J., Dakis J., Fielding J., Lyle D., Daniel C., Bruce M., Virtue E. (2011). Improving the care of mentally ill patients in a tertiary emergency department: Development of a psychiatric assessment and planning unit. Australasian Psychiatry, 19(4), 350–353. - PubMed
    1. Care Quality Commission. (2014). Key findings for the national accident and emergency patient survey. Author.

LinkOut - more resources