Intensive Home Treatment Team Scotland

1
Intensive Home Treatment TeamScotland

• Dr Colin Crawford
• Consultant Psychiatrist

2
Forth Valley

• 1026 square miles
• 277,000 inhabitants
• From Boness (south east) to Crianlarich (north
  west) - travelling time of 1 hour 30 minutes

3
Research Findings

• Outcomes of Crises Before and After the
  Introduction of a Crisis Resolution Team
• (Johnson Et al in the BJ Psych 2005 Volume
  187
• Pages 68 - 75)
• Crisis Resolutions/Home Treatment Teams and
  Psychiatric Admission Rates in England
• (Gluber Et al in the BJ Psych 2006 Volume 189
  
• Pages 441 - 445)

4
Critical Success Factors

• Targeted
• Integrated
• Gatekeeping
• Multidisciplinary
• Training
• Accessible 24/7
• Mobile/Home Based Intervention

5
Assessments
Patient admitted at assessment 11 n134
Individual assessed, neither taken onto caseload
nor admitted 47 n592
Patient assessed and taken onto caseload 43
n542
6
Independent Evaluation

• Scottish Development Centre for mental health
  (SDC)
• Clients satisfaction questionnaire (CSQ - 8)
• 75 very satisfied with the service

7
Conclusions

• You can treat most acute psychiatric patients at
  home with a crisis team.
• Less than 20 (17.85) of assessed patients
  admitted during their episode of illness.
• 15 beds were closed after one year, representing
  a 20 reduction.
• Over the next 2 years, a further 20 reduction in
  in-patient demand.
• Good communication within the team and with
  external agencies is vital.