A comparative evaluation: Community-based, mental health crisis intervention treatment models and outcomes.

摘要

Mobile mental health crisis response services personnel provide community-based crisis intervention (CBCI) with the primary goals of stabilizing individuals in crisis within their own communities and avoiding emergency psychiatric hospitalization. While previous research has demonstrated the general efficacy of CBCI in meeting its goals, an important gap remains regarding whether particular models of intervention result in differential outcomes. In this quantitative archival study, cognitive behavioral therapy (CBT) was compared with person centered solutions based therapy (PCSBT) to examine differential outcomes on diversion from restrictive setting placement. Diversion also was compared across four presenting problems: mood, psychosis, personality, and other disturbance. Data on 1,440 cases were compiled from five community mental health centers across the United States. Results of chi-square tests of independence indicated that CBT resulted in greater than expected diversion rates compared to PCSBT. Findings also indicated that those presenting with mood disturbances were more likely to experience restrictive setting placement than those presenting with other problems. Results are discussed with respect to the non-experimental design limitations, but also with respect to potential best practice models for CBCI. A best practice model targeting the most efficacious treatment type for particular types of presenting problems could greatly enhance the goals of stabilizing individuals in crisis and avoiding emergency psychiatric hospitalization, thus contributing to social change in mental health care.