The contribution of the voluntary sector to mental health crisis care: a mixed-methods study

Newbigging, Karen; Rees, James; Ince, Rebecca; Mohan, John; Joseph, Doreen; Ashman, Michael; Norden, Barbara; Dare, Ceri; Bourke, Suzanne; Costello, Benjamin

doi:10.3310/hsdr08290

Cited by 28 publications

(69 citation statements)

References 84 publications

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“…In the current study, insufficient third sector resources were seen to constrain the use of signposting and timely discharge, the impact of which relied on adequate support in the community to promote accessibility. Geographical variations in third sector mental health provision have been identified in UK reports with some areas indicating falling funding in tandem with rising need (Newbigging et al, 2020). In the current study, similar challenges were highlighted by commissioners, who recognized the priority to assess and build sufficient resource provision across the system to support programme impact.…”

Section: Discussionmentioning

confidence: 99%

The impact of a needs‐based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i‐THRIVE Programme

Farr

Moore

Bruffell

et al. 2021

Child

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Background The i‐THRIVE Programme is a needs‐based model of care, based on the THRIVE Framework, that is being implemented across the United Kingdom with the aim of improving outcomes for children and young people's mental health and wellbeing. This study aimed to investigate the impact that this programme has on accessibility and quality of care, as viewed by key stakeholders. Methods Interviews with professionals and service users were conducted during the implementation of the THRIVE Framework in four sites of one mental health and community service provider. Results Three themes are identified: ‘impact of needs‐based groupings on referral’, ‘impact of collaborative and interagency approach’ and ‘impact of i‐THRIVE on clinical practice’. Findings suggest that accessibility was seen to be promoted through the integration of a needs‐based approach, flexible re‐referral, signposting and information sharing, the use of goal‐orientated interventions and collaboration over risk and treatment endings. Shared decision making was perceived to improve the experience of care for young people, as was interagency working. Goal‐focused interventions and upfront discussion of treatment endings were seen to help clinicians manage expectations and discharge but could also compromise effectiveness and engagement. Obstacles to impact were resistance to interagency working and a shortage of resources across the system. Conclusions i‐THRIVE is a promising approach with the potential to facilitate the accessibility and quality of mental health care. However, a tension exists between enhancing accessibility and quality of care, which points towards the importance of outcome and satisfaction monitoring. Obstacles to impact point to the importance of a whole‐system approach supported by sufficient resources across the locality.

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Section: Discussionmentioning

confidence: 99%

The impact of a needs‐based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i‐THRIVE Programme

Farr

Moore

Bruffell

et al. 2021

Child

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“…This study focusses on NHS-provided ADUs, but similar services are provided in the UK by the voluntary sector or by NHS-voluntary sector partnerships [14]. These typically provide more socially oriented and relational styles of care with a less medical focus, and are valued by users for being more responsive and flexible than NHS crisis services [35]. A significant difference is their support over longer periods, spanning more of a mental health crisis trajectory from emergence through to later stages of post-crisis recovery.…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Acute day units for mental health crises: a qualitative study of service user and staff views and experiences

Morant¹,

Davidson²,

Wackett

et al. 2021

BMC Psychiatry

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Background Acute Day Units (ADUs) provide intensive, non-residential, short-term treatment for adults in mental health crisis. They currently exist in approximately 30% of health localities in England, but there is little research into their functioning or effectiveness, and how this form of crisis care is experienced by service users. This qualitative study explores the views and experiences of stakeholders who use and work in ADUs. Methods We conducted 36 semi-structured interviews with service users, staff and carers at four ADUs in England. Data were analysed using thematic analysis. Peer researchers collected data and contributed to analysis, and a Lived Experience Advisory Panel (LEAP) provided perspectives across the whole project. Results Both service users and staff provided generally positive accounts of using or working in ADUs. Valued features were structured programmes that provide routine, meaningful group activities, and opportunities for peer contact and emotional, practical and peer support, within an environment that felt safe. Aspects of ADU care were often described as enabling personal and social connections that contribute to shifting from crisis to recovery. ADUs were compared favourably to other forms of home- and hospital-based acute care, particularly in providing more therapeutic input and social contact. Some service users and staff thought ADU lengths of stay should be extended slightly, and staff described some ADUs being under-utilised or poorly-understood by referrers in local acute care systems. Conclusions Multi-site qualitative data suggests that ADUs provide a distinctive and valued contribution to acute care systems, and can avoid known problems associated with other forms of acute care, such as low user satisfaction, stressful ward environments, and little therapeutic input or positive peer contact. Findings suggest there may be grounds for recommending further development and more widespread implementation of ADUs to increase choice and effective support within local acute care systems.

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“…Where there was missing data, second respondents nominated by our initial respondent were contacted and asked to complete these questions. Researchers (CDL, BLE, LC and RS) then checked remaining gaps and inconsistencies in the data, with reference to available public information including Trust websites and a directory of voluntary sector crisis services provided from a recently completed study (20). All participants and NHS Trust Chief Executives were then contacted by the study team and invited to check and correct any remaining inaccuracies.…”

Section: Data Validation and Cleaningmentioning

confidence: 99%

“…Dissatisfaction with access to and quality of crisis care in England has been a driver for a national service improvement programme, with a Crisis Care Concordat introduced in 2014 (19). The aim of the Concordat was to facilitate local innovation, which was already occurring in some areas as a response to identified gaps in service provision (20). A national survey by our group in 2016 revealed wide variations in the provision of crisis services, and the emergence of several new models across the country (21).…”

Section: Introductionmentioning

confidence: 99%

Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems

Dalton-Locke

Harju-Seppänen

Lyons

et al. 2021

Preprint

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Background: Inpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment at home; acute day services; and residential crisis services in the community) have recently been augmented by several new service models. These are intended to enhance choice and flexibility within catchment area acute care systems, but remain largely undocumented in the research literature. We therefore aimed to describe the types and distribution of crisis care models across England through a national survey. Methods: We carried out comprehensive mapping of crisis resolution teams (CRTs) using previous surveys, websites and multiple official data sources. Managers of CRTs were invited to participate as key informants who were familiar with the provision and organisation of crisis care services within their catchment area. The survey could be completed online or via telephone interview with a researcher, and elicited details about types of crisis care delivered in the local catchment area. Results: We mapped a total of 200 adult CRTs and completed the survey with 184 (92%). Of the 200 mapped adult CRTs, there was a local (i.e., within the adult CRT catchment area) children and young persons CRT for 84 (42%), and an older adults CRT for 73 (37%). While all but one health region in England provided CRTs for working age adults, there was high variability regarding provision of all other community crisis service models and system configurations. Crisis cafes, street triage teams and separate crisis assessment services have all proliferated since a similar survey in 2016, while provision of acute day units has reduced. Conclusions: The composition of catchment area crisis systems varies greatly across England and popularity of models seems unrelated to strength of evidence. A group of emerging crisis care models with varying functions within service systems are increasingly prevalent: they have potential to offer greater choice and flexibility in managing crises, but an evidence base regarding impact on service user experiences and outcomes is yet to be established.

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The contribution of the voluntary sector to mental health crisis care: a mixed-methods study

Cited by 28 publications

References 84 publications

The impact of a needs‐based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i‐THRIVE Programme

The impact of a needs‐based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i‐THRIVE Programme

Acute day units for mental health crises: a qualitative study of service user and staff views and experiences

Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systems

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