Supporting people with mental health crises at home

People who experience a mental health crisis can receive support in many different ways. One approach is to support people in their own home via a Crisis Resolution Home Treatment (CRHT) team. The CRHT team provides intensive support, which can include treatment, medication and support for carers. CRHT teams are usually made up of a number of mental health professionals, including a psychiatrist, mental health nurses and social workers. Teams are required to gatekeep all admissions to psychiatric inpatient wards and facilitate early discharge of service users.

What proportion of admissions to psychiatric wards are gate kept by CRHT teams?

It is hoped that the intensive, short-term support of a CRHT team could help to prevent hospital admissions. However, in some cases admission is still necessary. In cases where an admission is the result of a mental health crisis, CRHT teams should be involved in the decision to admit and should have assessed the service user prior to admission. The national threshold is that at least 95% of all admissions to psychiatric inpatient wards must be gate-kept by a CRHT team.

Since Q1 2010/11, the proportion of admissions to psychiatric wards which were gate-kept by CRHT teams has remained above the national threshold of 95%. There was a slight decrease to 96.3% in Q1 2015/16, but it has since increased and has been above 98% since Q4 2015/16.

Updated January 2018.

How has the number of admissions to psychiatric wards changed over time?

We saw previously that the proportion of psychiatric admissions gate-kept by CRHT teams has been fairly steady. Here, we see that the total number of admissions to psychiatric wards - along with those gate-kept by CRHT teams - has been falling. Total admissions dropped to a low of 15,599 in Q4 2014/15, and have since increased again to 16,734 in Q2 2017/18, although this is almost 2,000 less than Q1 2010/11. It is unclear from these data whether these reductions are due to the CRHT teams being able to prevent admissions and keep people at home, the number of crises decreasing, or a capacity issue with fewer spaces on wards to admit people. More information is needed to understand the reduction in these numbers.

Updated January 2018.

About this data

An admission has been gate-kept by a crisis resolution home treatment (CRHT) team if they have assessed the service user before admission and if they were involved in the decision-making process to admit.

For more information about this indicator, please see the guidance available from NHS England.

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