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High resource expenditure on acute care is a challenge for mental health services aiming to focus on supporting recovery, and relapse after an acute crisis episode is common. Some evidence supports self-management interventions to prevent such relapses, but their effect on readmissions to acute care following a crisis is untested. We tested whether a self-management intervention facilitated by peer support workers could reduce rates of readmission to acute care for people discharged from crisis resolution teams, which provide intensive home treatment following a crisis. We did a randomised controlled superiority trial recruiting participants from six crisis resolution teams in England. Eligible participants had been on crisis resolution team caseloads for at least a week, and had capacity to give informed consent. Participants were randomly assigned to intervention and control groups by an unmasked data manager. Those collecting and analysing data were masked to allocation, but participants were not. Participants in the intervention group were offered up to ten sessions with a peer support worker who supported them in completing a personal recovery workbook, including formulation of personal recovery goals and crisis plans. The control group received the personal recovery workbook by post. The primary outcome was readmission to acute care within 1 year. This trial is registered with ISRCTN, number 01027104. 221 participants were assigned to the intervention group versus 220 to the control group; primary outcome data were obtained for 218 versus 216. 64 (29%) of 218 participants in the intervention versus 83 (38%) of 216 in the control group were readmitted to acute care within 1 year (odds ratio 0·66, 95% CI 0·43–0·99; p=0·0438). 71 serious adverse events were identified in the trial (29 in the treatment group; 42 in the control group). Our findings suggest that peer-delivered self-management reduces readmission to acute care, although admission rates were lower than anticipated and confidence intervals were relatively wide. The complexity of the study intervention limits interpretability, but assessment is warranted of whether implementing this intervention in routine settings reduces acute care readmission. National Institute for Health Research.

\"Trauma-Informed Practices with Children and Adolescents is a sourcebook of practical approaches to working with children and adolescents that synthesizes research from leading trauma specialists and translates it into easy-to-implement techniques. The approaches laid out address the sensory and somatic experiences of trauma within structured formats that meet the \"best practices\" criteria for trauma informed care: safety, self-regulation, trauma integration, healthy relationships, and healthy environments. Each chapter contains short excerpts, case examples, and commentary relevant to the chapter topic from recognized leaders in the field of trauma intervention with children and adolescents. In addition to this, readers will find chapters filled with easily applied activities, methods, and approaches to assessment, self-regulation, trauma integration, and resilience-building. The book's structured yet comprehensive approach provides professionals with the resources they need to help trauma victims not just survive but thrive and move from victim thinking to survivor thinking using the current best practices in the field\"--Provided by publisher.

Police calls for service are an important conduit by which officers and researchers can obtain insight into public requests for police service. Questions remain, however, about the quality of these data, and, particularly, the prevalence of measurement error in the classifications of events. As part of the present research, we assess the accuracy of call-types used by police dispatchers to describe events that are responded to by police officers. Drawing upon a sample of 515,155 calls for police service, we explore the differences among initial call-types, cleared call-types, and crime-types as documented in crime reports. Our analyses reveal that although the majority of calls for service exhibit overlap in their classifications, many still exhibit evidence of misclassification. Our analyses also reveal that such patterns vary as a function of call- and crime-type categories. We discuss our findings in light of the challenges of the classification process and the associated implications.

Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care. To evaluate a 1-year programme to improve CRTs' model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research programme, trial registration number: ISRCTN47185233). Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated. All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI -1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes. The CRT service improvement programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.

The implementation of crisis response strategies, such as natural hazards, pandemics, and conflicts, is necessary during times of emergency. Despite the importance of these interventions, mental health outcomes in emergency situations remain poorly understood. There is a lack of research on the comparative effectiveness of different interventions. Therefore, this study addresses the following question: \"How do crisis interventions affect mental health outcomes in emergencies?\". This study aims to conduct a scoping review of the impact mechanisms of crisis intervention on the mental health of witnesses or participants in the context of emergencies. The study encompassed a wide array of studies, emphasizing the efficacy of several crisis intervention modalities, such as psychological first aid and trauma-focused therapy. Most of the existing results were based on hospitals, schools and communities as research scenarios. The findings revealed substantial beneficial effects on mental health outcomes, such as decreased symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Nevertheless, discrepancies in the efficacy were observed depending on the nature of the emergency, the model of intervention, and the demographic variables. The study highlights the intricate nature of executing crisis interventions during emergencies, taking into account aspects such as cultural sensitivity, resource availability, and the necessity for customized approaches. Crisis interventions are crucial in reducing the detrimental effects on mental health caused by emergencies. However, additional focused and enduring investigations are necessary to understand their efficacy in various emergency scenarios and demographics. Therefore, future research can further enrich psychological crisis intervention methods and deepen research on the impact of crisis intervention on mental health.

Background Crisis resolution teams (CRTs) have been established in several high-income countries to improve access to mental health services and to prevent unnecessary inpatient admissions. General crisis theory is one of the foundations underpinning the development of CRTs. However, little research has been conducted on what characterises the situations leading to contact with these services and the crisis reactions during CRT care. This study aimed to describe characteristics and situations leading to contact with CRTs and to explore and predict possible changes in crisis experience and coping after CRT treatment. Methods Participants of this Norwegian multicentre pre-post study included 546 CRT service users of 25 CRTs. No control group was included. The present study builds on data collected from service users and team workers. The main outcome variables were change in patient-reported crisis experience and crisis coping from start to end of treatment. We performed descriptive analysis of affected life domains, and linear mixed modelling to analyse how outcomes were associated with patients’ characteristics and treatment. Results At treatment initiation, service users reported high scores of crisis experience and coping difficulties. Several life domains were affected, particularly emotional-life domains, such as mental illness, suicide risk, and loneliness. Lower levels of crisis experience, and enhanced coping abilities were observed within a timeframe of eight weeks or less. Although the current study design cannot rule out a specific causal relationship, recovery was nevertheless associated with service satisfaction, practical support, medication management, and quick access to help. Psychiatric symptoms at start, previous mental illness, and collaboration with wards were negatively related to a favourable outcome. Conclusions CRT service users reported high levels of crisis experience and low levels of coping at treatment initiation. CRT treatment was associated with a decrease in severity and improvement in coping, although more severe mental health problems at the start were negatively related to recovery.

This article describes a peer support project developed and carried out by a group of experienced mental health professionals, organized to offer peer psychological support from overseas to healthcare professionals on the frontline of the COVID-19 outbreak in Wuhan, China. This pandemic extremely challenged the existing health care systems and caused severe mental distress to frontline healthcare workers. The authors describe the infrastructure of the team and a novel model of peer support and crisis intervention that utilized a popular social media application on smartphone. Such a model for intervention that can be used elsewhere in the face of current global pandemic, or future disaster response.

Crisis Education and Service Program Designs, is a guide for educators, administrators, and clinical trainers who may otherwise feel ill-prepared for the complex tasks of teaching, program development, supervision, and consultation in the crisis-care arena. The book provides a framework for more systematic inclusion of crisis content in health and human-service programs. Readers will find that this book fills the current gaps in knowledge and training, and fosters a more holistic practice by all human-service professionals. It shows how effective leadership, training, and timely support contribute to crisis workers' effective practice with people in crisis.

We need to understand the causes to inform prevention