As Gyles Glover and Sonia Johnson outline in the book ” Crisis Resolution and Home Treatment in Mental Health” : in England , in the early 1990’s, community mental health teams were the main providers of emergency intervention in the community. Most operated only 9am to 5 pm on weekdays. Tom Burns introduced home visiting for all assessments within this model in the late 1980’s ( Burns 1993) in a team in southwest London.
In the late 1980’s and early 1990’s various intensive home treatment teams were set up in Birmingham .
In 1995 John Hoult , recently arrived from Australia established the Psychiatric Emergency Team in the Yardley area of North Birmingham . Hoult drew on his experiences in Sydney.The Yardley team ( described in a previous post ( ” Open all Hours”) on this website under Research) has been an important model for the dissemination of intensive home treatment teams in England.This model was subsequently adopted throughout North Birmingham, Bradford and Islington, London.
John Mahoney , Chief Executive of the North Birmingham service became joint head of mental health in the English Department of Health in 1998; hence the strong influence of the North Birmingham model on national policy.
By the late 1990’s pressure for a new approach to management of psychiatric emergencies in England came from several sources. Ultimately, this led to the creation of the Mental Health Policy Implementation Guide in 2001. That document outlines the English ” template” for intensive home treatment teams.
Not everything in the document has been accepted, particularly the recommended target population . In particular, the exclusion of patients with a sole diagnosis of personality disorder, those with learning disabilities, and those over 65 ,has been questioned.
This guide is not just for intensive home treatment ( crisis resolution and home treatment teams in the document), but also outlines other recommended services-such as assertive community treatment ( assertive outreach) and early intervention in psychosis teams.