Implementation of the community crisis resolution team model in Hong Kong: a feasibility study

Abstract

Background Persons with severe mental illness (SMI) are vulnerable to mental health (MH) crises in the community. These crises often resulted in costly hospital admissions. Crisis Resolution Team (CRT) was implemented based on limited empirical evidence to address this problem. In 2001, UK implemented a national policy making CRT mandatory nationwide. Since then, more studies were performed on the effectiveness of CRT. It appeared CRT is cost effective in reduction of admissions. There was evidence of positive clinical outcome in comparison with standard care.

Hong Kong does not have a specific community crisis program for people with SMI. It is desirable for policy makers to consider alternatives to reduce hospital admissions and to strengthen community support for people with SMI.

Aims To evaluate the feasibility on the implementation of CRT Model in Hong Kong as a service to reduce hospital admissions.

Method A review of current evidence on the effectiveness of CRT model and assess the feasibility and desirability of such model for implementation in Hong Kong.

Results Evidence from observational studies and randomized controlled trials show CRT to be effective in the reduction of hospital admissions and inpatient days in the UK. CRT is also associated with higher acceptance from patients and family members than from standard care. CRT appears to be feasible against other service to address the acute needs of persons with SMI in reducing hospitalization.

Conclusion A preliminary assessment ruled out a number of alternatives in dealing with mental health crises in the community. Preliminary results suggested the CRT model might be a feasible and desirable solution. There is evidence on the effectiveness of such teams in the UK. Successful implementation of CRT service in Hong Kong will be a challenge for stakeholders of the mental health system.