The CORE service improvement programme for mental health crisis resolution teams: results from a cluster-randomised trial.

Background: 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.

Aims: 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).

National implementation of a mental health service model: A survey of Crisis Resolution Teams in England.

In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions.

Development of a measure of model fidelity for mental health Crisis Resolution Teams.

Background: Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable.

The CORE Service Improvement Programme for mental health crisis resolution teams: study protocol for a cluster-randomised controlled trial.

Background: As an alternative to hospital admission, crisis resolution teams (CRTs) provide intensive home treatment to people experiencing mental health crises. Trial evidence supports the effectiveness of the CRT model, but research suggests that the anticipated reductions in inpatient admissions and increased user satisfaction with acute care have been less than hoped for following the scaling up of CRTs nationally in England, as mandated by the National Health Service (NHS) Plan in 2000. The organisation and service delivery of the CRTs vary substantially.

Effective support for those who are "hard to engage": a qualitative user-led study.

Background: Up to 30% of people with mental health problems drop out of contact with mental health services with negative implications for continuity of care. Services with an assertive outreach approach aim to sustain engagement.

Aims: This study explored the perceptions and needs of people often described as "hard to engage" in order to understand more about how services can best support them.

Psychometric properties of a Mental Health Team Development Audit Tool.

Background: To assist in improving team working in Community Mental Health Teams (CMHTs), the Mental Health Commission formulated a user-friendly but yet-to-be validated 25-item Mental Health Team Development Audit Tool (MHDAT).

Aims: The present study aims to examine the psychometric properties of the MHDAT.

Method: Based on a sample of clinical psychologists (n  =  77) with experience of working in CMHTs, reliability of the MHDAT was explored by means of Cronbach's alpha, intraclass correlation and inter-rater correlation, followed by analysis of face validity, distribution of the total scores, frequency distributions for each item and missing values.

Creating a culture to deliver compassionate care.

The Delivering Dignity report by the Commission on Dignity in Care for Older People provides direction on how to improve care for older people, but a better understanding is needed of how to develop sustainable cultural change.

The social care component of multidisciplinary mental health teams: a review and national survey.

Background: The study reviewed the disciplinary composition of community mental health teams (CMHTs) and conducted a national survey of mental health providers in England and Wales to explore the determinants of the social care component of CMHTs.

Methods: A comprehensive literature review and a national survey of NHS mental health Trusts in England and Wales.

Results: The literature review showed that team composition was rarely well justified with regard to effectiveness, despite some evidence that greater professional diversity (i.

Revisiting job satisfaction and burnout in community mental health teams.

Background: Staff morale is critical to the effectiveness and viability of teams and the models of care that they are implementing.

Aims: To update the findings on burnout, job satisfaction and sources of high or low morale in teams since the national survey of community mental health teams published by the Journal of Mental Health in 1997.

Method: The literature on job satisfaction, stress and burnout in community mental health teams published between 1997 and 2010 is reviewed.

Working appreciatively to improve services for children and families.

Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems.