This pilot project aimed to implement and evaluate the impact on crisis service use of an intervention based on the Crisis Plus model, with High Intensity Users (HIU) to a Mental Health Liaison Team (MHLT) in an Emergency Department in rural East Anglia.
This service evaluation applied a case series approach and uncontrolled pre-post analysis. HIUs were offered an intervention, focused on the development of a formulation of distress and help seeking behaviour, followed by co-production of a multi-service support plan. Randomisation tests compared the average number of referrals to the mental health liaison and crisis teams in the six months pre and post intervention.
Fourteen service-users engaged in the intervention. The final sample comprised 100% White British females, ranging in age from 18 to 50, with presenting difficulties relating to Complex Emotional and Relational Needs. Following the intervention, 11 out of 14 service-users had fewer referrals to the MHLT and 9 out of 14 had fewer referrals to the crisis team. Randomisation tests revealed that these average reductions were statistically significant, with large effect sizes.
This data supports continued use of the intervention within the service. Whilst further effectiveness studies are needed, this project provides tentative evidence that this intervention may help reduce crisis service use for HIUs. A further larger-scale pilot project is underway.
The findings suggest that the Crisis Plus principles could be applicable to HIUs of MHLTs, through potentially reducing reliance on crisis services and improving clinical outcomes.
