eprintid: 10153196
rev_number: 8
eprint_status: archive
userid: 699
dir: disk0/10/15/31/96
datestamp: 2022-08-04 12:31:07
lastmod: 2022-08-04 12:33:45
status_changed: 2022-08-04 12:31:07
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Anderson, Katie
creators_name: Goldsmith, Lucy P
creators_name: Lomani, Jo
creators_name: Ali, Zena
creators_name: Clarke, Geraldine
creators_name: Crowe, Chloe
creators_name: Jarman, Heather
creators_name: Johnson, Sonia
creators_name: McDaid, David
creators_name: Pariza, Paris
creators_name: Park, A-La
creators_name: Smith, Jared A
creators_name: Stovold, Elizabeth
creators_name: Turner, Kati
creators_name: Gillard, Steve
title: Short-stay crisis units for mental health patients on crisis care pathways: systematic review and meta-analysis
ispublished: pub
divisions: C07
divisions: FH7
divisions: B02
divisions: UCL
divisions: D79
keywords: Psychiatric nursing; suicide; crisis care; emergency psychiatric
care; crisis unit
note: Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. 

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
abstract: BACKGROUND: Internationally, an increasing proportion of emergency department visits are mental health related. Concurrently, psychiatric wards are often occupied above capacity. Healthcare providers have introduced short-stay, hospital-based crisis units offering a therapeutic space for stabilisation, assessment and appropriate referral. Research lags behind roll-out, and a review of the evidence is urgently needed to inform policy and further introduction of similar units. AIMS: This systematic review aims to evaluate the effectiveness of short-stay, hospital-based mental health crisis units. METHOD: We searched EMBASE, Medline, CINAHL and PsycINFO up to March 2021. All designs incorporating a control or comparison group were eligible for inclusion, and all effect estimates with a comparison group were extracted and combined meta-analytically where appropriate. We assessed study risk of bias with Risk of Bias in Non-Randomized Studies - of Interventions and Risk of Bias in Randomized Trials. RESULTS: Data from twelve studies across six countries (Australia, Belgium, Canada, The Netherlands, UK and USA) and 67 505 participants were included. Data indicated that units delivered benefits on many outcomes. Units could reduce psychiatric holds (42% after intervention compared with 49.8% before intervention; difference = 7.8%; P < 0.0001) and increase out-patient follow-up care (χ2 = 37.42, d.f. = 1; P < 0.001). Meta-analysis indicated a significant reduction in length of emergency department stay (by 164.24 min; 95% CI -261.24 to -67.23 min; P < 0.001) and number of in-patient admissions (odds ratio 0.55, 95% CI 0.43-0.68; P < 0.001). CONCLUSIONS: Short-stay mental health crisis units are effective for reducing emergency department wait times and in-patient admissions. Further research should investigate the impact of units on patient experience, and clinical and social outcomes.
date: 2022-07-25
date_type: published
publisher: CAMBRIDGE UNIV PRESS
official_url: https://doi.org/10.1192/bjo.2022.534
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1967454
doi: 10.1192/bjo.2022.534
medium: Electronic
pii: S2056472422005348
lyricists_name: Johnson, Isabella
lyricists_id: ISJOH12
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
funding_acknowledgements: 17/49/70 [National Institute of Health Research (NIHR) Health Services and Delivery Research]
full_text_status: public
publication: BJPsych Open
volume: 8
number: 4
article_number: e144
pages: 14
event_location: England
citation:        Anderson, Katie;    Goldsmith, Lucy P;    Lomani, Jo;    Ali, Zena;    Clarke, Geraldine;    Crowe, Chloe;    Jarman, Heather;                                 ... Gillard, Steve; + view all <#>        Anderson, Katie;  Goldsmith, Lucy P;  Lomani, Jo;  Ali, Zena;  Clarke, Geraldine;  Crowe, Chloe;  Jarman, Heather;  Johnson, Sonia;  McDaid, David;  Pariza, Paris;  Park, A-La;  Smith, Jared A;  Stovold, Elizabeth;  Turner, Kati;  Gillard, Steve;   - view fewer <#>    (2022)    Short-stay crisis units for mental health patients on crisis care pathways: systematic review and meta-analysis.                   BJPsych Open , 8  (4)    , Article e144.  10.1192/bjo.2022.534 <https://doi.org/10.1192/bjo.2022.534>.       Green open access   
 
document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10153196/1/short-stay-crisis-units-for-mental-health-patients.pdf