Crisis Intervention

Weisman, Gilbert K.

doi:10.1007/978-1-4757-8979-9_5

Cited by 10 publications

(8 citation statements)

References 9 publications

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“…Such services aim to assess patients experiencing psychiatric crises in the community, where possible avoiding hospitalisation (Weisman, 1989). Although in recent decades such teams have been implemented across Australia, North America and now Europe, past research into their effectiveness has been limited.…”

Section: Discussionmentioning

confidence: 99%

Effects of a crisis resolution and home treatment team on in-patient admissions

Jethwa¹,

Galappathie

Hewson

2007

Psychiatr. bull.

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Aims and MethodTo evaluate the effects of a crisis resolution and home-based treatment team upon in-patient admission rates. We collected data for 2 years prior and 1 year post-implementation of such a service in Leeds. The chosen time frame allowed the new service to settle in and controlled for seasonal variations.ResultsThere were 4353 admissions during the period of the study, with 3325 in the 2 years prior to the service and 1028 in the year after. Generalised linear analysis found a 37.5% reduction in monthly admissions after the introduction of the team (P < 0.0001).Clinical ImplicationsThis study shows that in everyday clinical practice crisis resolution and home treatment teams lead to a sustained reduction in in-patient admission rates.

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Section: Discussionmentioning

confidence: 99%

Effects of a crisis resolution and home treatment team on in-patient admissions

Jethwa¹,

Galappathie

Hewson

2007

Psychiatr. bull.

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“…As indicated in Table 3, the more conclusive and consistent therapeutic interventions with moderate to large effect sizes in symptom control, relapse prevention, and levels of psychosocial functioning included patient and/or family psychoeducation programs,125 cognitive–behavioral therapy,126 and an integrated program with antipsychotics and different approaches to psychosocial care 127,128. Although small effect sizes to relapse prevention were found, a few commonly used approaches to psychosocial intervention for schizophrenia show increasingly consistent effects on specific patient outcomes, such as patients’ social and community functioning being improved by social and vocational skills and short-term competitive employment being enhanced by supported employment with work skills training 65,129…”

Section: Approaches To Treatment For Schizophrenia From Prodromal To mentioning

confidence: 99%

“…Similar to Amsterdam’s first-aid service in the 1970s, crisis intervention models for people with schizophrenia and other serious mental illnesses have at times emerged, aimed at treating psychiatric crises in the community and reducing relapses and/or the number of hospitalizations 129. Multidisciplinary, around-the-clock crisis intervention services advocate prompt detection of symptom exacerbation and immediate intensive treatments as needed (eg, psychotropic agents, individual and family counseling, psychological therapies, and practical assistance in activities of daily living) in both community and home settings.…”

Section: Approaches To Treatment For Schizophrenia From Prodromal To mentioning

confidence: 99%

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Chien¹,

Yip²

2013

NDT

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During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients’ needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have recommended that a combination of treatment modalities be adopted to meet the complex health needs of people with schizophrenia spectrum disorders. In view of the heterogeneity of the risk factors and the illness progression of individual patients, the use of multifaceted illness management programs consisting of different combinations of physical, psychological, and social interventions might be efficient and effective in improving recovery.

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“…Some people become aggressive, threatening harm to themselves or others. Intervention at this stage is crucial as it brings much needed relief for both the sufferer and their carers and can help prevent further deterioration (Weisman 1989).…”

Section: Introductionmentioning

confidence: 99%

Crisis intervention for people with severe mental illnesses

Murphy

Irving

Adams

et al. 2012

Cochrane Database of Systematic Reviews

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Background A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. Objectives To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with ‘standard care’. Search methods We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group’s Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. Selection criteria We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. Data collection and analysis We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. Main results Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments. Crisis intervention appears to reduce repeat admissions to hospital after the initial ‘index’ crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes. Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more satisfactory form of care for both patients and families and at three months after crisis, mental state is superior to standard care. We found no differences in death outcomes. Some studies found crisis interventions to be more cost effective than hospital care but all numerical data were either skewed or unusable. No data on staff satisfaction, carer input, complications with medication or number of relapses were available. Authors’ conclusions Care based on crisis intervention principles, with or without an ongoing home care package, appears to be a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.

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Crisis Intervention

Cited by 10 publications

References 9 publications

Effects of a crisis resolution and home treatment team on in-patient admissions

Effects of a crisis resolution and home treatment team on in-patient admissions

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Crisis intervention for people with severe mental illnesses

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