An interesting piece on the work and struggles of Crisis Teams written by a crisis team consultant.
The quote that most struck a chord with me: “What has been lost? Care. I have no doubt crisis teams provide great care to many people, and are usually staffed by individuals who want to do their best, but we fumble along trying to figure out just what that is.”
Crisis Resolution Teams (CRTs, also known as Home Treatment Teams, although they’re not quite the same thing) are ubiquitous, and since the 2000 NHS Plan, mandated in the UK. Wherever you live, there’s a dedicated team covering your area, but there ends the certainty. Whilst the Royal College of Psychiatrists runs a Home Treatment accreditation scheme (HTAS), certification is not necessary, and besides, it (intentionally) leaves wide-room for local interpretation. Does your team open 24 hours a day, or just until late evening? Do they provide care for individuals with substance misuse problems, formal psychoeducation on antipsychotics, or any specific interventions for those who self-harm or have accommodation issues? It’s left to services to try best-match local needs with staff skill mixes.
Of course, as a CRT Consultant I would (and do) reverse the argument: what should we do? What works? Problematically (for me), a commissioner might pose the same question: why should we fund you, or fund you in your current form? Therein lies the key problem in crisis care: a lack of good clinical data.