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Mental Health Foundation, Take Control: Self-management in care and treatment planning (2012)
Who a crisis resolution service is for:
The main target group will often be adults between 16-65 years of age, whose mental illness is of such severity that they are at risk of requiring psychiatric hospitalisation. The focus will generally be on individuals with either a psychotic or depressive illness who are currently experiencing an acute episode. Suicidal acts or threats, or acts or threats of violence towards others may be common scenarios when clients are first seen. Given these broad client referral types, the service must also be flexible, both in terms of age and psychiatric diagnosis. For example, a referred client who is over 65 years old can be accepted if he or she still receives adult services. Also, someone diagnosed with personality disorder or a dual diagnosis of mental illness and alcohol or substance misuse who is in crisis may also be accepted. Referrals will often need to be determined on an individual basis.
Who a crisis resolution service is not for:
Anxiety disorders: The service is not for people with mild anxiety disorders. For example, people with agoraphobia, who would probably benefit more from behavioural therapy.
Alcohol or substance abuse: Crisis services are also not for people with a primary diagnosis of alcohol or substance abuse. People who have mental illness as a primary diagnosis, may often have problems with alcohol or substance abuse as a result of their mental illness, but if this is not the case, appropriate specialist services should be sought.
Organic disorders: The service is also not for people with brain damage or other organic disorders, such as dementia.
Learning disabilities: Crisis resolution services cannot be expected to treat individuals with a primary diagnosis of learning disability. Referrals may however, be accepted where there is also a strong mental illness component present combined with a mild learning disability and no other local services are available.
Overdose cases with no mental illness: It is not appropriate to refer cases of individuals who have recently overdosed but who are not suffering from a mental or severe depressive illness.
Relationship issues and situations of domestic violence: Again, if mental illness is not a feature in such situations, this would be an inappropriate referral.
Deciding eligibility criteria
It is important to determine whom the service is for before the team takes action. The service manager should develop a clear written policy to be circulated to potential referrers. These would include local GPs, A&E (accident and emergency) departments as well as CMHTs (community mental health teams). Where possible, some face-to-face management discussions about referrals should occur before the team becomes operational. Such a policy should state both acceptance and exclusion criteria. However, it may only be the actual trial and error of operational practice that refines these criteria. (p.13-14)