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. 2025 Mar 18;25(1):404.
doi: 10.1186/s12913-025-12396-3.

Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study

Laura Saez  1   2 , Laken Ndjoh Eton  3 , Valérie Demessance  3 , Amélie Rundstadler  3 , Emilie Harquet  3 , Fabienne Lemetayer  4 , Caroline Soler  3
Affiliations

Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study

Laura Saez et al. BMC Health Serv Res. .

Abstract

Background: Though promising, the implementation of crisis resolution teams has been unequal across Europe. In France, their deployment is currently receiving interest but there is to date no national policy and the research is scarce.

Methods: In the present study a psychiatric service converted one of its two inpatient wards into a crisis resolution team (EPSIAD) enabling a quasi-experimental naturalistic design. Variables on admissions, length of hospital stay and patient satisfaction were collected and analysed in the year preceding and the year following the conversion.

Results: In the year following the EPSIAD implementation, there were more admissions of female patients (41.0% vs 49.5%, p = 0.0262), a five-day decrease in the length of hospital stay (p < 0.0001) and increased patient satisfaction, with a particular increase in clarity of information, quality of the relationship with the care staff and service and feeling involved in medical decisions (p < 0.0001).

Conclusions: The results of the present study indicate that the combination of a hospital ward with a crisis resolution team has the potential to increase global quality of care by providing a complementary mental health service. Crisis resolution teams may provide a viable alternative to hospitalisation that increases patient satisfaction and allows new patients to receive intensive care, with women especially benefiting from care at home. There is a need to cater for patients refusing psychiatric care altogether and hospital inpatient wards might specialise in involuntarily-admitted patient care.

Keywords: Access to mental health care; Acute psychiatric care; Community mental health service; Crisis resolution team; Home treatment; Involuntary admissions; Length of hospital stay; Satisfaction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained by the Ethics Committee of the Metz-Jury Mental Health Hospital (Comité éthique de l’Etablissement Publique de Santé Mentale Metz-Jury). This study was conducted in accordance with the Helsinki Declaration and national guidelines. Waiver of consent for non-interventional research. According to the French Code de la santé publique (Public health code), as in force at the relevant time, there was no need for informed consent because the research conducted is non-interventional. Thus, the Legislative part of the Public health code, First book on the Protection of persons in the health sector, Title II of which is entitled ‘Biomedical research’ sets out the rules governing consent. Non-interventional research is defined, in Article L1121-1 ( https://www.legifrance.gouv.fr/codes/article_lc/LEGIARTI000032722870/2020-07-21 ), as ‘research … which poses no risk or force in which all medical acts and products are used routinely’. Whereas for other types of research, explicit and informed consent is necessary, non-interventional research is always permitted unless a person has refused to be the subject of research (Article L1122-1–1, https://www.legifrance.gouv.fr/codes/article_lc/LEGIARTI000032722892/2020-07-21 ). None of the persons involved in the present study refused being the subject of research. Consent for publication: Non applicable. Competing interests: The authors declare no competing interests.

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