Effect of crisis resolution team treatment on crisis experience and crisis coping: a multicenter pre-post study in Norway.

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.