Crisis resolution and intensive home treatment teams

Crisis resolution teams (CRT) have been introduced throughout England in the past 5 years, as mandated by current government policy. Their main roles are rapid assessment of all crises severe enough to warrant hospital admission and provision of short-term intensive home treatment instead of admission whenever feasible. They gatekeep acute beds, so that admission should not occur unless CRT staff agree they are necessary, and they also aim to facilitate early discharges from wards. While there is a consensus on some basic organizational principles, there are still considerable variations between teams in philosophy of care and range of interventions delivered. Care provided usually includes home visits up to twice a day, dispensing and monitoring of medication, help with solving pressing practical problems, education about mental health problems and how they are treated, and work with families and wider social systems. There is now some evidence that this form of care reduces hospital admissions and that service users may prefer it to admission. We still do not know whether these teams produce better outcomes than enhanced community mental health teams that work extended hours and offer intensive home treatment as one of a range of functions.