Outcomes of crises before and after introduction of a crisis resolution team

BACKGROUND: Crisis resolution teams (CRTs) are being introduced throughout England, but their evidence base is limited. AIMS: To compare outcomes of crises before and after introduction of a CRT. METHOD: A new methodology was developed for identification and operational definition of crises. A quasi-experimental design was used to compare cohorts presenting just before and just after a CRT was established. RESULTS: Following introduction of the CRT, the admission rate in the 6 weeks after a crisis fell from 71% to 49% (OR 0.38, 95% CI 0.21-0.70). A difference of 5.6 points (95% CI 2.0-8.3) on mean Client Satisfaction Questionnaire (CSQ-8) score favoured the CRT. These findings remained significant after adjustment for baseline differences. No clear difference emerged in involuntary hospitalisations, symptoms, social functioning or quality of life. CONCLUSIONS: CRTs may prevent some admissions and patients prefer them, although other outcomes appear unchanged in the short term.