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Chisholm & Ford, Transforming Mental Health Care: Assertive outreach and crisis resolution in practice (2004)
Learning points:
• In practice it is quicker to go and see people who may have been inappropriately referred, rather than have a lengthy dispute. This approach may also reduce inappropriate hospital admissions. But it must be done within a framework of proper risk management.
• Risk must be assessed and then managed.
• Over time teams need to be diplomatic, supporting and educating relatively inexperienced GPs and junior psychiatrists.
• Alternatives to CR, such as helplines, are important for people who need some help but not CR.
• Alternatives to hospital, such as crisis houses, can be supported by CRTs.
• Caseloads have to be carefully managed with some users being discharged within a couple of days. In the case of all users the intensity of care needs to be reduced through negotiation with the user. (p.49)