Finding the right care in a crisis by Dr Derek Tracy (courtesy of @MentalElf) | Positive Practice in Mental Health – National Awards

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.

The backdrop is their original design and intent (Carpenter et al 2013): ‘gatekeepers’ intended to reduce admission rates and durations, with an unspoken expectation that ‘good’ would be somehow contained within. Far more so than in 2000 when this was first established, we live in a time of bed crises: 2017 has already seen this as almost consistent headline news. So, it’s not an unreasonable starting point to have a team mandated with helping to resolve this. However, it sets up a clinical, management, and academic conversation that has spinning wheels as its focus: crisis teams, crisis teams, hey-hey-hey, how many admissions did you avoid today?


[Full post:]

2 thoughts on “Finding the right care in a crisis by Dr Derek Tracy (courtesy of @MentalElf) | Positive Practice in Mental Health – National Awards

  1. Curious what a dry piece this is. The thing is that crisis team intervention is all about people not illness. My GP called the crisis team twice with me. Long before the current NHS crisis, I found them useless and impersonal. They actually belittled my issues to my face. It was like they forgot I was the person in crisis and they were meant to be there to help me. As soon as they decided an admission was not necessary, it was like I didn’t exist.

    Liked by 1 person

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