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The Core Study

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Item 23

Offering choice in how support is provided

Target

a) Accepting medication is not a precondition for receiving CRT care. 

b) Service users' preferences regarding treatment options are considered and reflected in treatment plans.

c) The CRT meets service users in a range of locations (not just a casualty department or hospital sites) where home visiting is not possible or not wanted by the service user.

d) The CRT arranges the time of visits to fit around service users' or carers' preferences or commitments (e.g. work, childcare).

Why this is important

Offering choice in the types of CRT support provided can help engagement and delivery of helpful, individualised care. In the interviews for the CORE study, all stakeholders agreed that CRTs must be willing to work where possible with people who are refusing medication, to respect people's wishes and to be able to avoid hospital admissions. Service users may prefer not to be visited at home in some circumstances (such as if n shared accommodation) to preserve their privacy or ensure a quiet space. Flexibility about the timing of visits can help service users to continue with other valued activity or allow involved family to attend.

Ways of doing this well

Making service users aware of treatment options

Treatment plans

Examples of good practice

In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:

  • Bristol Intensive Team, Avon & Wiltshire Mental Health Partnership NHS Trust
  • South Camden CRT, Camden & Islington NHS Foundation Trust
  • South Wiltshire Intensive Service, Avon & Wiltshire Mental Health Partnership NHS Trust
  • Sunderland, Northumberland, Tyne and Wear NHS Foundation Trust
  • Telford and the Wrekin CRT, South Staffordshire & Shropshire Healthcare NHS Foundation Trust
  • Wyre Forest, Bromsgrove and Redditch HTT, Worcestershire Health and Care NHS Trust
  • Pontypool CRHTT, NHS Wales
  • Northamptonshire South CRHTT, Northamptonshire Healthcare NHS Foundation Trust
  • West Suffolk HTT, Norfolk & Suffolk NHS Foundation Trust
  • South Gwent CRHTT, NHS Wales
  • Gateshead CRT, Northumberland, Tyne and Wear NHS Foundation Trust
  • Shropshire CRT, South Staffordshire & Shropshire Healthcare NHS Foundation Trust
  • South Tyneside Initial Response Team, Northumberland, Tyne and Wear NHS Foundation Trust
  • Bromley HTT, Oxleas NHS Foundation Trust
  • Waltham Forest HTT, North East London NHS Foundation Trust
  • Surrey Heath HTT (Frimley), Surrey and Borders Partnership NHS Foundation Trust
  • Tower Hamlets HTT, East London NHS Foundation Trust
  • Redbridge HTT, North East London NHS Foundation Trust
  • Hastings CRT, Sussex Partnership NHS Foundation Trust
  • Adur, Arundle & Worthing CRHTT, Sussex Partnership NHS Foundation Trust
  • Eastbourne CRT, Sussex Partnership NHS Foundation Trust
  • Brighton & Hove CRHTT, Sussex Partnership NHS Foundation Trust
  • South East Essex (Rochford) CRHTT, South Essex Partnership University NHS Foundation Trust 
  • South East Kent (Canterbury) CRHTT, Kent and Medway NHS and Social Care Partnership Trust
  • Teignbridge CRHTT, Devon Partnership NHS Trust
  • North Devon CRHTT, Devon Partnership NHS Trust
  • East and Mid Devon CRHTT, Devon Partnership NHS Trust
  • Chichester CRHTT, Sussex Partnership NHS Foundation Trust
  • Edinburgh IHTT, NHS Lothian
  • Hammersmith CRHTT, West London Mental Health NHS Trust
  • Wolverhampton CRHTT, Black Country Partnership NHS Foundation Trust