Rojas-García Antonio, Dalton-Locke Christian, Sheridan Rains Luke, Dare Ceri, Ginestet Cedric, Foye Una, Kelly Kathleen, Landau Sabine, Lynch Chris, McCrone Paul, Nairi Shilpa, Newbigging Karen, Nyikavaranda Patrick, Osborn David, Persaud Karen, Sevdalis Nick, Stefan Martin, Stuart Ruth, Simpson Alan, Johnson Sonia, Lloyd-Evans Brynmor
NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK; and Department of Psychiatry, University of Granada, Spain.
Division of Psychiatry, University College London, UK.
BJPsych Open. 2023 Nov 3;9(6):e209. doi: 10.1192/bjo.2023.595.
In England, a range of mental health crisis care models and approaches to organising crisis care systems have been implemented, but characteristics associated with their effectiveness are poorly understood.
To (a) develop a typology of catchment area mental health crisis care systems and (b) investigate how crisis care service models and system characteristics relate to psychiatric hospital admissions and detentions.
Crisis systems data were obtained from a 2019 English national survey. Latent class analyses were conducted to identify discernible typologies, and mixed-effects negative binomial regression models were fitted to explore associations between crisis care models and admissions and detention rates, obtained from nationally reported data.
No clear typology of catchment area crisis care systems emerged. Regression models suggested that provision of a crisis telephone service within the local crisis system was associated with a 11.6% lower admissions rate and 15.3% lower detention rate. Provision of a crisis cafe was associated with a 7.8% lower admission rates. The provision of a crisis assessment team separate from the crisis resolution and home treatment service was associated with a 12.8% higher admission rate.
The configuration of crisis care systems varies considerably in England, but we could not derive a typology that convincingly categorised crisis care systems. Our results suggest that a crisis phone line and a crisis cafe may be associated with lower admission rates. However, our findings suggest crisis assessment teams, separate from home treatment teams, may not be associated with reductions in admission and detentions.
在英格兰，已经实施了一系列心理健康危机护理模式以及组织危机护理系统的方法，但对其有效性相关特征的了解却很少。
（a）建立集水区心理健康危机护理系统的类型学，（b）研究危机护理服务模式和系统特征与精神病医院入院和拘留之间的关系。
危机系统数据来自2019年英格兰全国调查。进行潜在类别分析以识别可辨别的类型学，并拟合混合效应负二项式回归模型，以探讨危机护理模式与从国家报告数据中获得的入院率和拘留率之间的关联。
没有出现集水区危机护理系统的明确类型学。回归模型表明，在当地危机系统中提供危机电话服务与入院率降低11.6%和拘留率降低15.3%相关。提供危机咖啡馆与入院率降低7.8%相关。与危机解决和家庭治疗服务分开设置危机评估团队与入院率提高12.8%相关。
在英格兰，危机护理系统的配置差异很大，但我们无法得出一种能令人信服地对危机护理系统进行分类的类型学。我们的结果表明，危机电话线和危机咖啡馆可能与较低的入院率相关。然而，我们的研究结果表明，与家庭治疗团队分开的危机评估团队可能与入院和拘留人数的减少无关。
