BMJ  2005;331:599 (17 September), doi:10.1136/bmj.38519.678148.8F (published 15 August 2005)

Paper

Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study

¹ Department of Mental Health Sciences, Royal Free and University College Medical Schools, University College London, London W1W 7EY, ² Camden and Islington Mental Health and Social Care Trust, London NW1 0PE, ³ CORE (British Psychological Psychology), Sub-Department of Clinical Health Psychology, University College London, London WC1E 7HB, ⁴ Central and North West London Mental Health NHS Trust, London W2 6LA, ⁵ MRC Biostatistics Unit, Cambridge CB2 2SR, ⁶ Department of Clinical Psychology, University of Surrey, Guildford, Surrey GU2 7XH

Objective To evaluate the effectiveness of a crisis resolution team.

Design Randomised controlled trial.

Participants 260 residents of the inner London Borough of Islington who were experiencing crises severe enough for hospital admission to be considered.

Interventions Acute care including a 24 hour crisis resolution team (experimental group), compared with standard care from inpatient services and community mental health teams (control group).

Main outcome measures Hospital admission and patients' satisfaction.

Results Patients in the experimental group were less likely to be admitted to hospital in the eight weeks after the crisis (odds ratio 0.19, 95% confidence interval 0.11 to 0.32), though compulsory admission was not significantly reduced. A difference of 1.6 points in the mean score on the client satisfaction questionnaire (CSQ-8) was not quite significant (P = 0.07), although it became so after adjustment for baseline characteristics (P = 0.002).

Conclusion Crisis resolution teams can reduce hospital admissions in mental health crises. They may also increase satisfaction in patients, but this was an equivocal finding.

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