Practice Based Evidence | A Mental Health Blog

Based on discussions from two workshops with the Great Yarmouth & Waveney Home Treatment Team

Tensions frequently arise between clinical teams, based on the real or perceived lack of clarity in defining what a crisis is, and the different interpretations of the term. Differences may arise within and between teams, through issues of definition and 'thresholds of tolerance' of a crisis situation between people (inc. practitioners).
At the broadest level, the definition of a crisis lies in the eye of the beholder - if a person asking for help says the situation is a crisis, then it is a crisis.
However, this definition is not very helpful for supporting a Home Treatment Team to focus its resources, as G.P.'s could potentially refer anyone in 'distress'.
For the purpose of a mental health Home Treatment Team the potential population can be narrowed by introducing a medical screening element through the need for a 'psychiatric diagnosis'; and refined further by specifying elements of 'risk'.
However, the degree of serious imminent risk may also result in the situation being defined as a psychological emergency, for which emergency services not the Home Treatment Team are most appropriate.
At the point of referral, it is important to help referrers differentiate between a crisis and an emergency, to help identify the most immediate and appropriate response. A large majority, but not all emergencies occur in the context of a crisis.
Home Treatment Team's may work with emergency situations within the longer context of a period of crisis intervention, but they are not the most appropriate first line of response in a sudden emergency.