Evaluation of an emergency response service

Tacchi, Mary Jane; Joseph, Suresh; Scott, Jan

doi:10.1192/pb.27.4.130

Cited by 4 publications

(1 citation statement)

References 2 publications

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“…In Johnson's two samples from 2005 37% and 40% had a psychotic disorder [ 8 , 9 ]. But the evidence is not wholly consistent; In a study of Barker et al from Edinburgh they found that 17% of the patients had psychotic symptoms [ 13 ]) and Tacchi found 13.5% with psychosis in a home treatment emergency response service in Newcastle [ 40 ]. With the lack of a randomized control group in this study, we cannot tell whether the patients would have progressed without CRT care (see the "Strengths and limitations" section below).…”

Section: Discussionmentioning

confidence: 99%

Treatment and outcomes of crisis resolution teams: a prospective multicentre study

2011

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BackgroundCrisis resolution teams (CRTs) aim to help patients in acute mental health crises without admitting them to hospital. The aims of this study were to investigate content of treatment, service practice, and outcomes of crises of CRTs in Norway.MethodsThe study had a multicentre prospective design, examining routine data for 680 patients and 62 staff members of eight CRTs. The clinical staff collected data on the demographic, clinical, and content of treatment variables. The service practices of the staff were assessed on the Community Program Practice Scale. Information on each CRT was recorded by the team leaders. The outcomes of crises were measured by the changes in Global Assessment of Functioning scale scores and the total scores on the Health of the Nation Outcome Scales between admission and discharge. Regression analysis was used to predict favourable outcomes.ResultsThe mean length of treatment was 19 days for the total sample (N = 680) and 29 days for the 455 patients with more than one consultation; 7.4% of the patients had had more than twice-weekly consultations with any member of the clinical staff of the CRTs. A doctor or psychologist participated in 55.5% of the treatment episodes. The CRTs collaborated with other mental health services in 71.5% of cases and with families/networks in 51.5% of cases. The overall outcomes of the crises were positive, with a small to medium effect size. Patients with depression received the longest treatments and showed most improvement of crisis. Patients with psychotic symptoms and substance abuse problems received the shortest treatments, showed least improvement, and were most often referred to other parts of the mental health services. Length of treatment, being male and single, and a team focus on out-of-office contact were predictors of favourable outcomes of crises in the adjusted model.ConclusionsOur study indicates that, compared with the UK, the Norwegian CRTs provided less intensive and less out-of-office care. The Norwegian CRTs worked more with depression and suicidal crises than with psychoses. To be an alternative to hospital admission, the Norwegian CRTs need to intensify their treatment and meet more patients outside the office.

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Section: Discussionmentioning

confidence: 99%

Treatment and outcomes of crisis resolution teams: a prospective multicentre study

2011

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A Profile of Mental Health Crisis Response in a Rural Setting

Bonynge

Lee

Thurber

2005

Community Ment Health J

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Systems of crisis intervention are frequently difficult to operationalize; they are often described as crisis components rather than systems, fail to differentiate levels of crisis acuity, provide very limited fundamental utilization data, and are almost exclusively implemented in urban areas. A system of rural crisis intervention differentiating levels of acuity and fundamental utilization information was profiled. Implications for clinicians and administrators are presented. This system of crisis intervention was highly effective in reducing inpatient utilization with the help of crisis residential beds and partial hospitalization. Mobile response was infrequently used in this setting. Age and gender were important variables in mental health emergency situations. Use of acute crisis level services was rarely more than once. More systematic descriptions of crisis systems of care were encouraged.

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Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

Britton

Patrick

Wenzel

et al. 2011

Cognitive and Behavioral Practice

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Cognitive Behavioral Therapy (CBT) has been found to be effective in preventing suicide-related behavior. However, it is often difficult to engage patients who are at-risk in treatment. Motivational Interviewing (MI) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments. As a general theory of human motivation that is consistent with MI, Self-Determination Theory (SDT) provides a framework for understanding how MI may be added to CBT to increase treatment engagement and effectiveness. In this paper, we use SDT to explain how MI may complement CBT to reduce suicide-related behavior, provide a case example of using MI with a suicidal patient before CBT-based treatment, and explore future directions for research.In the United States, over 300,000 people died by suicide between 1995 and 2005, making suicide a major public health concern (Centers for Disease Control and Prevention, 2008). Although an estimated 90% of individuals who die from suicide suffer from one or more mental disorders, up to 65% never receive psychological or psychiatric treatment (Cavanagh, Carson, Sharpe, & Lawrie, 2003). Psychosocial interventions such as Cognitive Behavioral Therapy are effective in reducing suicide-related behaviors (CBT; Tarrier, Taylor, & Gooding, 2008); thus, it is important to use theoretically and empirically supported methods to ensure that at-risk clients receive effective mental health treatment. Motivational Interviewing (MI;Miller & Rollnick, 2002) has been shown to increase treatment engagement and improve treatment outcomes when it is used to complement other treatments (Hettema, Steele, & Miller, 2005). However, MI is a clinical approach that currently lacks an underlying theory to explain the mechanisms by which it functions. As a general theory of human motivation that is consistent with the underlying principles of MI, Self-Determination Theory (SDT; Deci & Ryan, 2002) provides a framework for understanding the manner in which MI can be integrated with CBT to increase treatment Correspondence concerning this article should be addressed to Peter C. Britton, Ph.D., Center of Excellence, Department of Veteran Affairs Medical Center, 14424. peter.britton@va.gov. U.S. Department of Veterans AffairsPublic Access Author manuscript Cogn Behav Pract. Author manuscript; available in PMC 2016 October 19. Cognitive Behavioral Therapy (CBT) to Reduce Suicidal BehaviorIn a recent meta-analysis of 28 randomized controlled trials (RCTs), CBT was found to reduce suicide-related behavior (i.e., death by suicide, suicide attempts, suicide intent and/or plans, and ideation) in the 3 months following treatment (Tarrier et al., 2008). The primary cognitive behavioral interventions that were represented in the study included Dialectical Behavioral Therapy (DBT), problem-solving therapy, and Cognitive Therapy (CT). Although the findings were promising, a review of the major studies suggested that attrition was a common problem. For example, in Brown's ...

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Evaluation of an emergency response service

Cited by 4 publications

References 2 publications

Treatment and outcomes of crisis resolution teams: a prospective multicentre study

Treatment and outcomes of crisis resolution teams: a prospective multicentre study

A Profile of Mental Health Crisis Response in a Rural Setting

Integrating Motivational Interviewing and Self-Determination Theory With Cognitive Behavioral Therapy to Prevent Suicide

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