Involving relatives in emergency psychiatry: an observational patient‐control study in a crisis resolution and home treatment team

Oenen, Flip Jan van; Schipper, Suzy; Van, Rien; Visch, Irene; Peen, Jaap; Cornelis, Jurgen; Schoevers, Robert A.; Dekker, Jack

doi:10.1111/1467-6427.12189

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Psychological interventions and family involvement were not included in the final models of factors associated with outcomes. In a Dutch study of patients treated by a crisis and home treatment team, the involvement of relatives was not associated with differences in patient-reported outcome levels of psychiatric symptoms [ 42 ]. However, due to limitations in the study, the authors state that this should be studied further with more rigorous methods.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway

Ruud,

Hasselberg,

Siqveland

et al. 2024

BMC Psychiatry

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Background Crisis resolution teams (CRTs) have become a part of mental health services in many high-income countries. Many studies have investigated the impact of CRTs on acute admissions to inpatient units, but very few studies have investigated patient-reported and clinician-reported outcomes for CRT service users. Our aims were to study patient-reported and clinician-reported outcomes of CRT treatment, how the outcomes were associated with characteristics of the service user and the treatment, and whether outcomes were different across CRTs. Methods The study was a pre-post observational multicenter study of 475 patients receiving treatment from 25 CRTs in urban and rural areas in Norway. There was no control group. Outcomes were change in mental health status reported by service users using CORE-10 and by clinicians using HoNOS. Patient satisfaction was measured using CSQ-8 at the end of the treatment. Components of CRT accessibility and interventions were measured by clinicians reporting details on each session with the service user. CRT model fidelity was measured using the CORE CRT Fidelity Scale version 2. We used paired t-tests to analyze outcomes and linear mixed modeling to analyze associations of the outcomes with the characteristics of service users and the treatment provided. Using independent t-tests, we analyzed differences in outcomes and patient satisfaction between two clusters of CRTs with differences in accessibility. Results The patient-reported outcomes and the clinician-reported outcomes were significantly positive and with a large effect size. Both were significantly positively associated with practical support and medication management and negatively associated with collaboration with mental health inpatient units. Patient satisfaction was high at the end of the treatment. CRTs with higher accessibility had a significantly better clinician-reported outcome, but no significant differences were reported for patient-reported outcomes or patient satisfaction. Conclusions CRT treatment led to improved symptom status as reported by patients and clinicians, as well as high patient satisfaction. Practical support and medication management were the interventions most strongly associated with positive outcomes. Some of the variations in outcomes were at the team level. Patient- and clinician-reported outcomes should be used more in studies on the effect of treatment provided by crisis resolution teams.

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Section: Discussionmentioning

confidence: 99%

Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway

Ruud,

Hasselberg,

Siqveland

et al. 2024

BMC Psychiatry

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“…La dernière perspective d'analyse montre quant à elle que l'intégration des proches dans le travail a le même impact sur le plan relationnel que le fait de ne pas les intégrer. Van Oenen et al (2017), qui se sont intéressés à l'impact de l'implication des proches dans l'intervention de crise à domicile, en arrivent à la même conclusion. Ne serait-il donc pas pertinent d'examiner ce qui se passe dans la relation patient/proche 156 afin de comprendre comment l'intervention de crise peut avoir un effet sur le système?…”

Section: Discussionunclassified

Vers une théorisation du vécu des patients et de leurs proches à la suite d’interventions de crise à domicile

2018

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Les prises en charge de crise à domicile – proposées par des équipes mobiles – visent à intervenir auprès de patients en situation de détresse psychologique aiguë, et ce, dans un contexte où les proches sont systématiquement mobilisés dans la dynamique de soins. Les interventions s’étendent sur une période de trois à six semaines et ont comme visée la résolution de la crise individuelle et/ou familiale. À ce jour, l’efficacité de ce type de traitement n’est plus à prouver puisqu’il permet de réduire significativement le nombre d’hospitalisations. À travers notre étude, nous avons accordé une place aux patients et à leurs proches afin de les laisser exprimer leur vécu quant aux spécificités de ce dispositif de soins. L’objectif était de comprendre comment le patient et ses proches s’approprient de nouvelles stratégies de résolution de problèmes et comment ils acquièrent une meilleure compréhension de leur fonctionnement, individuel et relationnel, dans le but de prévenir d’éventuelles nouvelles crises. La vision bilatérale, c’est-à-dire le vécu des patients et de leurs proches, que nous proposons a abouti à une théorisation enracinée apportant des éléments de compréhension nouveaux quant à la manière dont les équipes de crise intervenant à domicile doivent continuer à soutenir les patients et leurs familles.

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“…With the explicit intention of providing contextual and multifaceted crisis intervention, CRTs aim to involve and collaborate with carers and other parts of informal and professional networks [1,[20][21][22]. However, according to Morant et al [16], the original family and social systems approach to home-based crisis intervention appears to have been diluted in CRT practice.…”

Section: Introductionmentioning

confidence: 99%

Similarities and differences between service users’ and carers’ experiences of crisis resolution teams in Norway: a survey

et al. 2022

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Background Crisis resolution team (CRT) care in adult mental health services is intended to provide accessible and flexible short-term, intensive crisis intervention to service users experiencing a mental health crisis and involve their carers (next of kin). Research on users’ and especially carers’ experiences with CRT care is scarce and is mostly qualitative in nature. Methods Altogether, 111 service users and 86 carers from 28 Norwegian CRTs were interviewed with The Service User and Carer Structured Interviews of the CORE Crisis Resolution Team Fidelity Scale Version 2. Their experiences with different aspects of CRT care were reported with descriptive statistics, and differences between service users’ and carers’ experiences were analyzed with the Mann-Whitney U Test. Results The service users and carers reported that the CRT care mostly reflected their needs and what they wanted. The experiences of service users and carers were mostly similar, except for significant differences in received information and how the termination of CRT care appeared. Both groups experienced the organization of the CRT care as accessible, with continuity, reliability, and flexibility, but without a high intensity of care. Both groups found the content of the CRT care supportive, sensitive, with a choice of treatment type and a range of interventions beyond medication, but a lack of written treatment plans and discharge plans. Carers were rarely involved in discharge meetings. Regarding the role of CRTs within the care system, both groups agreed upon the lack of facilitation of early discharge from inpatient wards and lack of home treatment, but both groups confirmed some collaboration with other mental health services. Conclusion Service users and carers found that the CRTs were accessible, reliable, flexible, supportive, sensitive, and provided a range of interventions beyond medication. Limitations were lack of a high intensity of care, limited written treatment and discharge plans, limited provision of home treatment, and lack of gatekeeping of acute beds. Both groups experienced the CRT care as mostly similar, but with significant differences regarding involvement in care planning and discharge preparation.

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Involving relatives in emergency psychiatry: an observational patient‐control study in a crisis resolution and home treatment team

Cited by 6 publications

References 26 publications

Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway

Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway

Vers une théorisation du vécu des patients et de leurs proches à la suite d’interventions de crise à domicile

Similarities and differences between service users’ and carers’ experiences of crisis resolution teams in Norway: a survey

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