Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study.

BACKGROUND

Though promising, the implementation of crisis resolution teams has been unequal across Europe. In France, their deployment is currently receiving interest but there is to date no national policy and the research is scarce.

METHODS

In the present study a psychiatric service converted one of its two inpatient wards into a crisis resolution team (EPSIAD) enabling a quasi-experimental naturalistic design. Variables on admissions, length of hospital stay and patient satisfaction were collected and analysed in the year preceding and the year following the conversion.

RESULTS

In the year following the EPSIAD implementation, there were more admissions of female patients (41.0% vs 49.5%, p = 0.0262), a five-day decrease in the length of hospital stay (p < 0.0001) and increased patient satisfaction, with a particular increase in clarity of information, quality of the relationship with the care staff and service and feeling involved in medical decisions (p < 0.0001).

CONCLUSIONS

The results of the present study indicate that the combination of a hospital ward with a crisis resolution team has the potential to increase global quality of care by providing a complementary mental health service. Crisis resolution teams may provide a viable alternative to hospitalisation that increases patient satisfaction and allows new patients to receive intensive care, with women especially benefiting from care at home. There is a need to cater for patients refusing psychiatric care altogether and hospital inpatient wards might specialise in involuntarily-admitted patient care.