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Evaluation of an emergency response service

Crisis Assessment and Treatment Service, Ravenswood Clinic, Ravenswood Rd, Heaton, Newcastle upon Tyne NE6 5TX

Suresh Joseph, Consultant Psychiatrist

Newcastle General Hospital, Newcastle upon Tyne

Jan Scott, Professor of Research in Psychological Treatments

Institute of Psychiatry, London

AIMS AND METHOD

An emergency response service (ERS) was introduced to streamline the assessment of individuals presenting in a crisis in one sector of a large provincial city. Data on service activity, clinical details and outcome were recorded on consecutive referrals to the service over the first 6 months of operation, and all patients were offered the opportunity to complete the Client Satisfaction Questionnaire.

RESULTS

Seventy-five per cent of those referred accepted the offer of assessment, and the majority were seen in their own home within 2 hours. One in ten individuals were not offered any further mental health input and 17% were hospitalised. The number of admissions via primary care fell by 60% after the introduction of this service. However, at its peak of activity the service received an average of only two referrals per day and three each weekend. Only 30% of referrals were received outside of normal office hours. Service users and general practitioners were found to be more satisfied with the service than the staff that provided it.

CLINICAL IMPLICATIONS

The introduction of the ERS led to a faster, more consistent process of assessment of crisis referrals and assessment undertakings in the community, and appeared to increase the use of alternative treatments for individuals in crisis before resorting to admission. Funding opportunities are restricted for the development of crisis services. The development of emergency response services for the use of current staff from a number of community mental health teams is an option worth considering.

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