Crisis Services

What are crisis and intensive home treatment teams?

Crisis and intensive home treatment team provide specialist assessment for people who need urgent mental health care. They assess and identify needs, including mental health, physical health, social care, any risks, strengths and hopes for recovery.

Teams often include a range of professionals such as nurses, psychologists, occupational therapists, social workers, support workers, doctors and trainee staff. Once they have assessed a person’s mental health needs they will work with them to plan the next steps of their recovery. This may include a referral to another service or a period of intensive home treatment.

Intensive home treatment may include:

  • psychological wellbeing / talking therapies
  • information sharing
  • medicine
  • staying well planning and self-management with an emphasis on recovery
  • accessing other services to assist with health promotion.

Collaboration is essential to recovery focused care planning, therefore service users and their carers or family members are as important in this process as the mental health team that supports individuals. Personal goals should be their main priority.

Crisis assessment

This assessment helps the crisis team to understand the factors involved in a mental health crisis. They will ask about current health, including physical wellbeing and any sources of stress a person may be experiencing. The person experiencing a crisis should be encouraged to share any previous experiences that have been beneficial or any existing care they are receiving from mental health services. The assessment time can vary and the person should be given plenty of time to tell the assessor about their problems.

The place/venue for the assessment should be agreed with the person prior to the assessment. Family, carers or supporters should be encouraged to be involved in the assessment.

Some people recover quicker and with a greater sense of independence at home rather than being admitted to hospital, and as such crisis teams will always try to deliver intensive mental health care in the community.

Intensive home treatment

This treatment is an alternative to hospital admission and is delivered in the community. Crisis teams can provide psychological wellbeing/ talking therapies and medical (medicine) treatments for a range of mental health difficulties. Professionals can come to see people several times a day and will gradually reduce involvement once the mental health crisis begins to resolve. Care should be reviewed every day and people may be introduced to more than one health care team member to help their recovery. Sometimes people may need additional mental health care. If this is the case, the crisis team staff will talk to you about this and agree the next steps.

 

 

Real life experience

I went to my GP in crisis, I was desperate and distressed. I was referred immediately for assessment by the mental health team. After this assessment I was given a couple of appointments the following week, one with a community psychiatric nurse and one with a psychiatrist. I was very upset that nothing could be done immediately to ease the pain I was feeling, being handed the telephone number for the crisis team as I was ushered out the door made me feel even more desperate and alone. The piece of paper became my life line even though I didn’t know how to use it. I had loads of questions which my distressed mind answered for me.

What would happen if I called the team?
You will be sectioned.

What will happen if I call the team?
They will tell you not to be so stupid.

What will happen if I call the team?
They will tell me I am wasting their time.

What will happen if I call the team?
There will be no answer and I will feel even worse.

These questions went round and round in my head increasing my distress and bewilderment as to what I should do.

Eventually I could stand it no longer and late into the evening I called the crisis team. As the phone rang I stood shaking in nervous anticipation, no longer knowing or caring what the response was going to be. The phone was answered and instantly I knew I was talking to someone who was going to listen and who seemed to be genuinely interested helping me. I was encouraged to explain everything that was going on and as I did so I felt my heightened state of distress calm ever so slightly. My desperate babbled calmed down into words that began to make more sense and I was able to say what I needed to say. I was desperate and I was suicidal and as much as I wanted to die I also really didn’t want to. I was at an impasse and it was driving me crazy. After a long conversation I was exhausted and all I wanted to do was go to bed, no longer having any desire to act in any harmful way for now. I agreed to an urgent appointment the following day.

Having made that first phone call I have since called the crisis team for support on many occasions. Not all calls have been as helpful or as positive. I have been told to make a cup of tea or have a bath which as isolated suggestions has been more damaging than helpful, making me feel invalidated and more desperate. But on the whole I have found the crisis team a good source of support, I just wish I had known what to expect from the beginning.