The Implementation of Crisis Resolution Home Treatment Teams in Wales: Results of the National Survey 2007-2008



Richard Jones1, 2, Sue Jordan*, 2
1 Hywel Dda NHS Trust, Hafan Derwen, Parc Dewi Sant, Carmarthen, SA31 3BB, UK
2 School of Health Science, Swansea University, Swansea, SA2 8PP, UK


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© Jones and Jordan; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the School of Health Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK; Tel: 01792 295789/518541; Fax: 01792 295487; E-mail: S.E.Jordan@swansea.ac.uk


Abstract

Background:

In mental health nursing, Crisis Resolution and Home Treatment (CRHT) services are key components of the shift from in-patient to community care. CRHT has been developed mainly in urban settings, and deployment in more rural areas has not been examined.

Aim:

We aimed to evaluate CRHT services’ progress towards policy targets.

Participants and Setting:

All 18 CRHT teams in Wales were surveyed.

Methods:

A service profile questionnaire was distributed to team leaders.

Findings:

Fourteen of 18 teams responded in full. All but one were led by nurses, who formed the main professional group. All teams reported providing an alternative to hospital admission and assisting early discharge. With one exception, teams were ‘gatekeeping’ hospital beds. There was some divergence in clients seen, perceived impact of the service, operational hours, distances travelled, team structure, input of consultant psychiatrists and caseloads. We found some differences between the 8 urban teams and the 6 teams serving rural or mixed areas: rural teams travelled more, had fewer inpatient beds, and less medical input (0.067 compared to 0.688 whole time equivalents).. Most respondents felt that resource constraints were limiting further developments.

Implications:

Teams met standards for CHRT services in Wales; however, these are less onerous than those in England, particularly in relation to operational hours and staffing complement. As services develop, it will be important to ensure that rural and mixed areas receive the same level of input as urban areas.

Keywords: Mental health nursing, crisis resolution, home treatment, rurality.