Resolving the psychiatric bed crisis: a critical analysis of policy

Abstract

The National Service Framework (NSF) for Mental Health in 1999 was central to the modernisation of mental health services under the New Labour government of 1997. It placed an emphasis on universal clinical standards and set out a vision for service developments over the next 10 years. One such proposal was the development of crisis resolution teams, aimed at reducing the psychiatric admissions rate by providing care at home. This article provides a critical analysis of policies relating to the provision of 24-hour access to mental health services, focusing on the specifications for creating crisis resolution teams, as laid out in the NSF for Mental Health and the NHS Plan. First, it looks at the historical context surrounding the policy, examining the content of the NSF and NHS plan and how policy was disseminated and implemented nationally and locally. Then it examines the effects and changes this policy brought about and, specifically, whether it has achieved its aims of reducing the nationwide acute psychiatric inpatient admission rate.

Nurses experiences of working in Crisis Resolution Home Treatment Teams with its additional gatekeeping responsibilities

“…Gatekeeping as a role in itself is considered very challenging and demanding, requiring staff who are the forefront of service provision to possess a level of skill, expertise and knowledge in order to achieve the desired outcomes of a reduction in admissions, whilst managing high‐risk population groups within the community (Loader ). CRHTT also calls for staff to actively engage with family members and carers in order to achieve positive results and outcomes for service users within the comforts of their own homes.…”