‘Empowering people on their recovery journey’
Today (Friday, 26th May 2023), the HSE launches a new Model of Care for Crisis Resolution Services, to provide brief person-centred intensive supports in people’s home and community as an alternative to hospital admission.
This Model of Care was developed as a direct recommendation of ‘Sharing the Vision’, Ireland’s national mental health policy. It emerged from the recognition that people who are experiencing mental health crisis need specialist services to provide brief intensive supports in a timely way to support them in their recovery journey.
The needs for this service development are increasing, with circa 15,720 admissions to Irish psychiatric units and hospitals in 2021 and 1 to 3% of emergency department attendances are mental health presentations[i]. Self-harm, suicidal thoughts, substance misuse, anxiety/depression, and psychotic illness are the most common mental health presentations at triage in the ED setting. Crisis Resolution Services will be central to the acute mental health care pathway.
There are two key service components in Crisis Resolution Services:
- Crisis Resolution Teams will play a vital role by providing intensive mental health interventions and support in the patient’s home and the community as an alternative to a hospital admission. Evidence from practice indicates service users and carers value, and benefit from home and community interventions and supports. The Crisis Resolution Team will use the skills of the multidisciplinary team to assess the service user’s needs and to develop an individual care plan that supports them on their recovery journey.
- Crisis Café teams will provide an out-of-hours friendly and supportive community crisis prevention and crisis response service in the evenings and at weekends in a café style/non-clinical and safe environment. The café service, Solace Café, will support individuals and their family members/carers to manage their mental health and wellbeing, and link them in with relevant HSE and statutory providers.
Mary Butler, Minister for Mental Health and Older People, said: “The demand for a Model of Care for Crisis Resolution Services arose from the recognition that those experiencing mental health crisis often require specialist supports after hours and at weekends. This new Model of Care will offer brief person-centred intensive supports in a timely way to assist the service user in their recovery journey. Importantly, it will seek to offer an alternative response to inpatient admission. I look forward to the timely delivery of this service across the pilot sites.”
Yvonne Goff, National Director, Change and Innovation, HSE said: “This Model of Care is a key component of the HSE Mental Health Reform plans in the National HSE Corporate Plan and it’s aligned to National Strategic policies in Sláintecare and ‘Sharing the Vision: A Mental Health Policy for Everyone’. I would like to thank my Mental Health Change and Innovation Team for all their work in designing and developing this model of care, and for supporting the pilot sites in both their planning and delivery of Crisis Resolution Services. Thank you to the five pilot learning sites for accepting to co-design and to pilot implement this exciting and innovative initiative and to acknowledge their work and commitment to date. We are also grateful to all the key stakeholders that we engaged with in the design and development of this initiative.”
The new HSE Crisis Resolution Service Model of Care aims to provide mental health intensive supports in individuals' homes or communities as an alternative to hospital admission.
This approach is important for individuals who suffer from mental difficulties for several reasons:
- Timely and person-centred support: The model recognises that people experiencing mental health crises require specialist services that can provide brief intensive support in a timely manner. By offering support in the home or community, the model aims to respond quickly to individuals' needs and empower them on their recovery journey.
- Avoiding hospital admission: Hospital admissions can be distressing and disruptive to individuals' lives. By providing intensive supports outside of hospital settings, the model seeks to offer an alternative response and reduce the need for inpatient admissions when appropriate. This can help individuals maintain a sense of normalcy and continuity in their daily lives.
- Multidisciplinary team approach: Crisis Resolution Teams play a vital role by delivering intensive mental health interventions and support in the patient's home and community. These teams consist of professionals from various disciplines who assess the individual's needs and develop an individual care plan tailored to support their recovery journey. This multidisciplinary approach ensures that individuals receive comprehensive and holistic care.
- Community crisis prevention and response: Crisis Café teams, operating in a non-clinical safe environment, provide an out-of-hours service aimed at preventing crises and offering support during evenings and weekends. These teams offer a friendly and supportive space where individuals and their family members/carers can manage their mental health and wellbeing. The Crisis Café service emphasises effective signposting to relevant services provided by the HSE and other third-sector and statutory providers.
- Learning and evaluation: The pilot implementation of the Crisis Resolution Service will undergo an independent evaluation over the testing phase of 18-24 months. This evaluation will help assess whether the desired outcomes are being met and inform future development of the service. By continuously learning and adapting based on the evaluation results, the HSE can improve the model and ensure it effectively meets the needs of individuals with mental difficulties.
Both Co-chairs of the National Steering Group, John Meehan, HSE Assistant National Director for Mental Health Operations Planning, and Dr Amir Niazi, HSE National Clinical Lead for Mental Health, added: “We would like to thank each member of the National Crisis Resolution Services Steering Group, who demonstrated ongoing dedication and commitment to this project and who worked hard to enrich the final document with their own perspective and experience. We would also like to thank the project team for their excellent work in driving this work forward and for leading on the design and development of this model of care.”
Overall, this new Model of Care for Crisis Resolution Services aims to provide more accessible and personalised support to individuals with mental health difficulties, empowering them on their recovery journey and offering an alternative to hospital admission when appropriate.
It will be piloted across five pilot learning sites in the next 2 years in;
- Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo
- Midwest Community Healthcare
- Cork Kerry Community Healthcare
- South East Community Healthcare
- Community Healthcare Dublin South, Kildare and West Wicklow.
There will be an independent evaluation undertaken of the pilot implementation of Crisis Resolution Service over the pilot testing phase.
Last updated on: 26 / 05 / 2023