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The aim of this study is to benchmark the impact of the Crisis Resolution Home Treatment Team (CRHTT) on the elderly admission rate as well as the duration of admission

Data were collected for a period of one year before (August 2006 to July 2007) and after (August 2007 to July 2008) the extension of CRHTT input into elderly services.

There was an overall reduction in the number of admissions after CRHTT got involved with the elderly.

This study only considered individuals with functional disorders who were admitted to the in‐patient services or referred to the CRHTT. However, these only make up a proportion of the elderly in‐patients.

The study will help identify areas which may further help in reducing the admissions.

This is an original study that acknowledges the reduction in admission following the introduction of a crisis resolution home treatment team in Trafford, Manchester.

This paper seeks to explore staff experiences of working in Crisis Resolution and Home Treatment (CRHT). There is a paucity of research in the area and a particular lack of in‐depth qualitative accounts of staff experiences with most research focused on output and outcomes of CRHTs, including inpatient admission and bed‐occupancy rates.

Interpretative phenomenological analysis (IPA) was used to investigate participants' experiences of working in this service context. Five CRHT workers were interviewed about their experiences, including the aspects of their work that they found enjoyable and those that they found stressful, and how they coped with challenges related to the work.

Three master themes, each with corresponding subordinate themes, emerged from the analysis. These were: “motivating factors”, “stressors” and “coping”. These findings indicated these subjective experiences emphasised the opportunities to make a difference and help service users and build therapeutic relationships. Perceived stressors were understood in the context of a complex service context, operational issues, responsibility for service users, and supervision and training needs.

The implications of the research for CRHT staff are discussed as well as the limitations of this study.

This study offers a timely development in understanding the experiences of staff working in CRHTs.

There has been a rapid development and implementation of crisis resolution home treatment teams (CRHTT) in the UK over the past decade. The available research studies of this service provision to date have largely focused on issues related to the “outputs” of CRHTT, for example cost efficacy and the impact on admission rates. There is limited research on the experiences of clinical psychologists within CRHTT. This is despite the fact that it would seem that research exploring the experiences of mental health professionals in CRHTT is important, as working in a new area of service provision may present specific challenges. An understanding of the nature of these challenges is considered important in order to support clinical psychologists in these settings, and to sustain and improve service delivery.

–This study presents a qualitative exploration of clinical psychologists’ experiences of working in a CRHTT. In total, 11 clinical psychologists were interviewed about their perceptions of working within CRHTT, their relationships with other professionals and their experiences of working with service users in “crisis”. The grounded theory approach was employed to analyse participants’ accounts.

–Two themes were identified: psychological and clinical work and teamwork. The emergent themes are compared to the wider literature on clinical psychologists’ experiences of working in teams, and working with service users in “crisis”.

This research demonstrates the value of a clinical psychology perspective in acute mental health settings. It also highlights the value of a clinical psychological perspective in multi-disciplinary team working. It draws attention to the need for clinical psychologists working in CRHTT settings to be able to more clearly articulate their roles in these services. It points to the importance of clinical psychologists considering the interventions they provide to service users with complex presentations. Also, it highlights their need to consider the psychological interventions they provide in CRHTT settings more generally, as this area of work does not closely align with NICE guidelines.

Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis.

This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019.

There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service.

Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team.

This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.

Peter Relton is employed as a service user development worker in the Bradford Home Treatment Team. His job is to challenge and develop the team ‐ to bring his insights and perspectives to bear on the way they do their work. While some ‘user workers’ operate from a position somewhat apart from the local team, Peter describes an approach that has the potential to knit a service user perspective right into the fabric of mental health services.

The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if the use of acute services was also affected via a service evaluation project.

The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data.

The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance.

PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.

Families play an instrumental role in helping relatives experiencing mental health issues to stay well. In the context of wider initiatives promoting family and carer needs, this study aims to evaluate the feasibility, acceptability and potential benefits of bespoke training to develop clinicians’ skills in working with families in crisis.

The study was an uncontrolled evaluation of a one-day workshop for home treatment team staff using pre- and post-questionnaires.

In total, 83 staff members participated. Overall, there was a strong agreement for the involvement of families, which increased marginally after training. There were significant changes in views about talking to family members without service user consent (p = 0.001) and keeping them informed of their relative’s well-being (p = 0.02). Qualitative feedback indicated that participants enjoyed the interactive elements, particularly role-playing. Training provided an opportunity to practice skills, share knowledge and facilitate the integration of family work into their professional role.

Confident support for families contributes to effective mediation of crisis and continuation of care; factors important in reducing admission rates and protecting interpersonal relationships. Overall, the consistency of responses obtained from participants suggests that this workshop offers a helpful introduction to a family approach at times of a mental health crisis.

This pilot evaluation suggests this new one-day workshop, is a feasible and acceptable training program, which is beneficial in developing clinicians’ skills in working with families in a crisis.

The Coventry Community Personality Disorder Service is a new service that has been developed successfully over the past two years, despite several challenges such as real difficulties with recruitment. This is a description of our model, its implementation and some of the emergent issues we encountered along the way.