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Table 1 Comparison studies of different CRT models - study characteristics and outcomes

From: Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review

Study Reference MMAT score Study characteristics CRT models compared Results
Allen (2009) [31] n/a Natural experiment with pre- and post-comparison; Buckinghamshire, UK CRT team pre and post several organisational changes: “patient typing” system categorising service user needs introduced; greater use of leave from hospital to promote early discharge; referrals to CRT from other mental health services accepted without reassessment; structured screening tools introduced for acute assessments; closer links between CRT and day hospital introduced with single key worker system Reduction in inpatient bed provision and greater service user satisfaction reported following changes. No statistical tests or numerical results reported
Doyle (1994) [32] 3 Natural experiment with parallel groups: 1 Team in Folkestone, UK 1 Team in Barnet, UK Folkestone CRT with 9 am-5 pm opening hours No clear difference between CRT models reported and no statistical tests reported. Over the follow-up period
Barnet CRT with 24 hour opening
9% of the 9-5 (Folkestone) CRT service users were admitted to hospital vs 5% Barnet
Happell (2009) [33] 3 Natural experiment with pre- and post-comparison of parallel groups; Melbourne, Australia Control Group: Day after initial assessment, full assessment given by trainee psychiatrist, care management plan formulated. Mean HoNOS scores not significantly different between the groups at baseline – no p-values reported
Treatment Group: Day after initial assessment, full assessment given by nurse practitioner, who took role of trainee psychiatrist (After 7 days service users in nurse-initiated care group reverted to treatment as usual) HoNoS scores for both groups significantly improved with treatment (difference for control group: t = 7.90, df = 51, p < .001; difference for treatment group: t = 6.90, df = 50, p < .001) No information given as to whether there was a significant difference between group HoNOS scores after treatment.
Service user and carer satisfaction scores were reported as not significantly different between groups – no p-values given
Harrison (2011) [34] 3 Natural experiment with pre- and post-comparison of a single CRT; Manchester, UK • In 2005 (‘pre’), referrals were only taken from secondary services. • 301 people treated in a six-month period in 2008/09, 128 in a comparable period in 2005
• In 2008-2009 (‘post’), referral routes extended to primary care.
• Mean duration of contact in 2008/09 – 24 days, in 2005 – 69 days
• 39% in 08/09 already known to services and in receipt of Care Plan Assessment (CPA), 70% in 05 (P < 0.005)
• Increase in proportion treated for less severe illnesses (less severe depression and other diagnoses) in 2008/09 compared with 2005 (increase from 25 to 50%, P < 0.0001)
• Fewer treated with severe mental illness (schizophrenia and related disorders, bipolar disorder and psychotic depression); 50% in 08/09, 75% in 2005, P < 0.0001
Reding (1995) [35] 4 Retrospective natural experiment with pre- and post-comparison; Kalamazoo County, Michigan, USA • Comparison of before and after the introduction of a psychiatrist to the team There were significantly fewer state hospital admissions in the team with a psychiatrist (p < 0.001). (The decrease in state hospital admissions was not offset by a corresponding increase in admissions to the local private psychiatric hospital.)