493 Crisis intervention effective in severe mental illness

December 03, 2016

written by Brian R McAvoy.

Clinical question

How effective are crisis intervention models for people with serious mental illness experiencing an acute episode, compared with standard care?

Bottom line

Crisis care, with or without an ongoing home care package, provided support that was worthwhile, acceptable and less expensive than standard care. Furthermore, crisis care avoided repeat admission to hospital, improved the mental state of service users more than standard care, was more acceptable and satisfactory to service users and placed a lower burden on families and carers. There were no differences in death rates between crisis intervention and standard care. There were no data on staff satisfaction, carer input, complications with medication or number of relapses. Follow-up ranged from 3–24 months.

Caveat

The review includes only 8 studies. The methods of most of these studies were considered poor and there was no definitive description of crisis intervention or crisis care for studies performed before 2006, meaning there was a lack of focus on crisis care in its pure form. Most studies excluded service users with alcohol or drug misuse, and those who were in danger of being harmful to themselves or others.

Context

A particularly difficult challenge for community treatment of people with serious mental illness is the delivery of an acceptable level of care during their acute phases. Crisis care, where support is provided during a crisis for service users in their home or a community setting, offers a possible solution.

Cochrane Systematic Review

Murphy SM et al. Crisis intervention for people with severe mental illnesses. Cochrane Reviews, 2015, Issue 12. Art. No.: CD001087.DOI: 10.1002/14651858. CD001087.pub5. This review contains 8 studies involving 1144 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.