Home treatment teams: what should they do? A qualitative study of patient opinions

BACKGROUND: Home treatment teams (HTTs) have limited evidence of altering hospital admissions. There is no consensus on what HTTs "do", and a considerable lack of data on whether they deliver patient-relevant meaningful care. The Royal College of Psychiatrists has recently established the Home Treatment Accreditation Scheme (HTAS) to institute a quality standard for HTTs, though it is unclear whether such accreditation could of itself measure effective care. AIMS: To explore opinions of HTT service users on the care they received to guide future research and service provision. METHOD: Ten ex-HTT patients were interviewed on the care they had received, using thematic analysis of semi-structured interviews. RESULTS: Positive aspects of HTT intervention included a rapid, accessible and crisis-focused approach, though changing staff and appointment times were considered unhelpful. Proposals were made for greater psycho-and occupational-therapeutic inputs to manage long-term care, and for provision of peer-support within HTTs. CONCLUSIONS: HTTs were valued but service users' focus was on goals notably different to factors generally assayed by existing research. There is a severe lack of longitudinal clinical and patient-centred outcome data. HTAS provides a potential vehicle through which this could be addressed.