Social systems intervention and crisis resolution. Part 2: Intervention

Abstract

Home treatment as an alternative to acute adult in-patient care is part of the National Health Service's Plan for mental health services in the UK. As a form of crisis intervention, it benefits from an understanding of, and ways of working with, the social systems relevant to the patient in crisis. This article describes the social systems intervention process as an alternative to admission and also considers its application in achieving early in-patient discharge.This is the second part of a two-part article. Part 1 (Bridgett & Polak, 2003, this issue)

The future of specialist community teams in the care of those with severe mental illness

“…Special training of staff is probably needed for those in such teams so that old practices that do not work can be replaced with those that do (Gournay & Thornicroft, 2000) and specific attention needs to be paid to adherence to medication (Garety et al, 2006), vocational employment (Gold et al, 2006;Macias et al, 2006), partnership models (Priebe et al, 2005), regular quality control (Allevi et al, 2006), and both social and physical environments (Bridgett & Polak, 2003;Tyrer & Bajaj, 2005;Abas et al, 2006), as these are often critical in determining if hospital admission can be avoided. One of the strongest criticisms of these teams is that they are doing 'more of the same', and if 'the same' is inadequate there will clearly be no benefit.…”

Crisis resolution and home treatment: structure, process, and outcome - a literature review

“…There are only four papers that address clinical approaches in crisis resolution and home treatment. Bridgett & Polak (2003a,b) focused on social factors associated with admission and examine the social systems intervention process, both as an alternative to admission and as an element in early inpatient discharge, stressing the importance of home treatment and the network.…”

“…Home treatment is described as safe, effective, and comprehensive in 80% of all cases (Bristol Mind 2004, Crisholm & Ford 2004, Karlsson & Hultberg 2007). Home treatment has advantages over inpatient treatment in several aspects (Bridgett & Polak 2003a,b, Harvey & Fielding 2003, Johnson 2007, Karlsson & Hultberg 2007, Karlsson et al . 2008a):…”

“…Family is the most proximal and close network for service users. Bridgett & Polak (2003a,b) described a connection between social system intervention and crisis resolution, specifically pointing out that the social system is often a part of the problem and plays an important role in the solution. They developed a participatory model for crisis resolution involving the network, and found in its application that the network members often show their good will and desire to participate.…”

Profile and activities of a rural home-based psychiatric treatment service in Ireland

“…It promotes a patient-centred approach to assessment and treatment while also allowing for identifying and addressing the concerns of family. Other attributes of HBT include the rapid assessment of patients and facilitation of early discharge from hospital (Bridgett and Polak 2003).…”