Department of Health Sciences, The University College of Buskerud, Drammen, Norway.
J Psychiatr Ment Health Nurs. 2010 Dec;17(10):881-92. doi: 10.1111/j.1365-2850.2010.01621.x. Epub 2010 Aug 26.
• During the last ten years there has been a major change in developing mental health services generally, and crisis resolution and home treatment (CRHT) services especially. Many Western countries have made a shift in perspective from in-hospital care to home treatment. The new approach is based on treating people who experience mental health crises in their homes instead of through hospitalization. • Most of the published articles on CRHT focus on structural issues pertaining to the development of home treatment services, and on macro-level outcomes such as cost-effectiveness and admission rates. These have political, economic, and practical implications. Few articles describe clinical intervention methods used in home treatment. • This paper explores how home treatment is described as an essential intervention method in crisis resolution at home in relation to three key characteristics of CRHT, which are being mobile, working in the service user's home, and working together with the person's family and network. • There remains a need for further research describing specific characteristics of home treatment, different clinical interventions that are used by CRHT teams, and the directions with which clinical interventions need to be developed further. It is critical to investigate what makes the interventions of the CRHT teams different from the hospital care, and how this affects the service users, the family and the networks, and the professionals.
The objective of this paper is to explore and systematize the existing knowledge regarding the structure, process, and outcome of crisis resolution and home treatment (CRHT) as a form of community mental health service. Data sources are published peer-reviewed articles. Our study selection is systematic search for peer-reviewed articles written in English and Norwegian published between January 2000 and December 2008. Data are extracted from review of published articles on the subject of CRHT team and home treatment. We identified 35 articles including 6 reviews, consisting of quantitative and qualitative studies. The knowledge regarding CRHT focuses on three areas: (1) structure in terms of the standards, organization, and development; (2) process in terms of clinical interventions; and (3) outcome in relation to cost-effectiveness and admission rates. While the structural issues were presented and discussed a great deal, there is a paucity of articles on clinical intervention methods in home treatment as well as a limited attention on outcomes at the micro-level. There is a need for further studies regarding the clinical work of CRHT teams from the home treatment perspective.
本文旨在探索和系统化危机解决和家庭治疗（CRHT）作为一种社区心理健康服务形式的结构、过程和结果的现有知识。数据来源为已发表的同行评议文章。我们的研究选择是系统地搜索 2000 年 1 月至 2008 年 12 月期间以英文和挪威文发表的关于 CRHT 团队和家庭治疗主题的同行评议文章。从关于 CRHT 团队和家庭治疗的已发表文章的综述中提取数据。我们确定了 35 篇文章，包括 6 篇综述，这些文章包括定量和定性研究。关于 CRHT 的知识主要集中在三个方面：（1）结构方面，包括标准、组织和发展；（2）过程方面，包括临床干预措施；（3）结果方面，涉及成本效益和入院率。虽然已经提出并讨论了很多结构性问题，但关于家庭治疗中的临床干预方法的文章却很少，而且对微观层面的结果关注也很有限。需要进一步研究 CRHT 团队从家庭治疗角度开展的临床工作。
