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

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 patients' satisfaction, but this was an equivocal finding.