Economic evaluation of a crisis resolution service:
A randomised controlled trial
1Health Service and Population Research Department, Institute of Psychiatry, King’s College London (United Kingdom)
2Department of Mental Health Sciences, Royal Free and University College Medical Schools,
University College London (United Kingdom)
3Camden and Islington Mental Health and Social Care Trust, London (United Kingdom)
4CORE (British Psychological Psychology), Sub-Department of Clinical Health Psychology,
University College London (United Kingdom)
5Central and North West London Mental Health NHS Trust, London (United Kingdom)
6Department of Clinical Psychology, University of Surrey, Guildford (United Kingdom)
paul mccrone, sonia johnson, fiona nolan, stephen pilling, andrew sandor, john hoult, nigel mckenzie, marie thompson, paul bebbington
SUMMARY. Aims – The use of specialised services to avoid admission to hospital for people experiencing mental health crises is seen as an integral part of psychiatric services in some countries. The aim of this paper is to assess the impact on costs and cost-effectiveness of a crisis resolution team (CRT). Methods – Patients who were experiencing mental health crises sufficient for admission to be considered were randomised to either care provided by a CRT or standard services. The primary outcome measure was inpatient days over a six-month follow-up period. Service use was measured, costs calculated and cost-effectiveness assessed. Results – Patients receiving care from the CRT had non-inpatient costs £768 higher than patients receiving standard care (90% CI, £153 to £1375). With the inclusion of inpatient costs the costs for the CRT group were £2438 lower for the CRT group (90% CI, £937 to £3922). If one less day spent as an inpatient was valued at £100, there would be a 99.5% likelihood of the CRT being cost-effective. Conclusion – This CRT was shown to be cost-effective for modest values placed on reductions in inpatient stays.
Declaration of Interest: No authors have any interests to declare.
KEY WORDS: costs and cost analysis, community mental health services, crisis intervention, economics.
Note: this is an economic evaluation of the North Islington RTC in the preceding post