2.4.2 Crisis Intervention and Home Treatment
Knowledge of the Theory and Practice of Crisis Intervention/Home Treatment
Psychiatric crises are acute episodes of mental health problems that require immediate intervention. In the UK, crisis intervention and home treatment services aim to provide rapid assessment, treatment, and support for individuals experiencing a psychiatric crisis. This essay will discuss the theory and practice of psychiatric crisis intervention and home treatment services in the UK.
Theory of psychiatric crisis intervention:
The theoretical basis of psychiatric crisis intervention lies in the biopsychosocial model of mental health, which suggests that mental health problems arise from a complex interaction between biological, psychological, and social factors. In a crisis situation, an individual’s ability to cope with these factors may be overwhelmed, leading to acute symptoms and a need for urgent intervention.
The goal of psychiatric crisis intervention is to stabilize the individual’s mental health and prevent harm to themselves or others. The intervention is based on the principle of least restrictive intervention, meaning that the intervention should be the least intrusive possible while still providing necessary care. The intervention is also focused on empowering the individual and promoting their autonomy and recovery.
Home treatment services in the UK:
In the UK, crisis intervention and home treatment services are typically provided by specialist community mental health teams. These teams consist of mental health professionals such as psychiatrists, nurses, and social workers, who are trained to provide rapid assessment, treatment, and support to individuals experiencing a psychiatric crisis.
The home treatment service aims to provide an alternative to hospital admission for individuals who are experiencing a psychiatric crisis but are deemed suitable for home treatment. The service provides a range of interventions, including medication management, psychological therapy, and social support. The team works closely with the individual and their family to develop a crisis plan and provide ongoing support to prevent future crises.
Risk assessment and risk management:
Risk assessment and risk management are key components of psychiatric crisis intervention and home treatment services. Risk assessment involves assessing the likelihood and severity of harm to the individual or others, while risk management involves developing strategies to prevent or reduce the risk of harm.
The risk assessment process involves a comprehensive evaluation of the individual’s mental health, history of self-harm or suicide attempts, current stressors, and social support. The risk assessment is ongoing throughout the crisis intervention process, and the team regularly monitors the individual’s mental state and risk of harm.
The risk management strategies may include medication management, psychological therapy, and crisis planning. The team works with the individual and their family to develop a crisis plan that outlines the steps to be taken in the event of a future crisis. The plan includes contact information for the crisis team and other support services, as well as strategies for managing the crisis.
| Aspect | Description |
| Theoretical basis | Biopsychosocial model of mental health |
| Goals | Stabilization of mental health and prevention of harm to self or others |
| Intervention | Least restrictive possible while still providing necessary care |
| Home treatment services in the UK | Rapid assessment, treatment, and support provided by specialist community mental health teams |
| Interventions | Medication management, psychological therapy, and social support |
| Risk assessment | Comprehensive evaluation of mental health, history of self-harm or suicide attempts, current stressors, and social support |
| Risk management | Strategies to prevent or reduce the risk of harm, including medication management, psychological therapy, and crisis planning |
| Crisis plan | Outline of steps to be taken in the event of a future crisis, including contact information for support services |
Psychiatric crisis intervention and home treatment services in the UK are based on the biopsychosocial model of mental health and aim to provide rapid assessment, treatment, and support to individuals Psychiatric crisis interventions or home treatment can be effective in preventing hospitalizations, providing support to patients, and improving outcomes. The goal of these interventions is to provide immediate assessment, stabilization, and treatment to patients in crisis, with the aim of preventing further deterioration and hospitalization.
Home treatment teams in the UK consist of psychiatrists, psychiatric nurses, occupational therapists, and social workers who work together to provide crisis intervention and short-term support to patients in their homes. These teams are typically available 24 hours a day, seven days a week, and can provide assessments, medication management, psychological interventions, and practical support to patients in crisis. Home treatment is an alternative to hospitalization and is often preferred by patients as it allows them to remain in their own homes and receive care from familiar healthcare professionals.
Research has shown that home treatment can be effective in reducing hospital admissions and readmissions, improving patient satisfaction, and reducing healthcare costs. A systematic review and meta-analysis conducted by Johnson et al. (2018) found that home treatment was associated with a reduction in the number of hospital admissions and bed days, as well as an improvement in patient outcomes such as symptoms, functioning, and quality of life.
However, there are also challenges associated with home treatment, including the need for adequate resources, training, and support for home treatment teams. Additionally, there is a need for clear and standardized protocols for the assessment, management, and follow-up of patients in crisis, as well as guidelines for the transfer of care between home treatment and hospital-based services.
Key elements of psychiatric crisis intervention/home treatment in the UK:
| Key elements | Description |
| Availability | Home treatment teams are available 24 hours a day, seven days a week |
| Assessment | Comprehensive psychiatric and physical assessment of patients in crisis |
| Stabilization | Immediate stabilization and management of acute symptoms |
| Treatment | Short-term treatment, including medication management and psychological interventions |
| Practical support | Assistance with practical issues such as housing, employment, and financial support |
| Transfer of care | Clear and standardized protocols for transfer of care between home treatment and hospital-based services |
| Resources | Adequate resources, training, and support for home treatment teams |
Reference:
- Johnson, S., Lamb, D., Marston, L., Osborn, D., Mason, O., Henderson, C., … & Nolan, F. (2018). Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial. The Lancet, 392(10145), 409-418. doi: 10.1016/S0140-6736(18)31470-3.