Person-centred crisis support services as alternatives to emergency departments: a systematic scoping review.

IF 3.6 2区 医学 Q1 PSYCHIATRY Social Psychiatry and Psychiatric Epidemiology Pub Date : 2024-10-10 DOI:10.1007/s00127-024-02776-1
Danielle Postorivo, Stephen Parker, Harvey Whiteford, Zoe Papinczak, Zoe Rutherford
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Abstract

Purpose: To identify, critically appraise, and synthesise the published and grey literature on person-centred crisis support services as an alternative to support in emergency departments (EDs) for people experiencing mental health crises. This scoping review explores the characteristics and outcomes of these services.

Methods: A systematic scoping review was undertaken to identify publications describing person-centred crisis support services and their outcomes. Search strings were applied to multiple databases, and publications were subjected to quality appraisal. The review process was informed by The Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR).

Results: Thirteen publications were included in the narrative synthesis, and these considered eight separate crisis support services. The methodological quality of the publications included was limited. Key findings were positive visitors' experiences, high rates of ED deflection, and overlaps between repeat visits, crises prevention, and hospital avoidance. Key recommendations included increasing opening hours and capacity and improving service awareness and accessibility.

Conclusions: The available evidence suggests that person-centred crisis support services are perceived by stakeholders as safe and effective alternatives to EDs for people experiencing mental health crises, providing more timely and appropriate care while reducing ED mental health presentations. Due to the limited quality of the publications included, high-quality research is needed to better understand the model and confirm the findings reported in this review.

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以人为本的危机支持服务作为急诊科的替代方案:系统性范围界定审查。
目的:对有关以人为本的危机支持服务的已发表文献和灰色文献进行识别、批判性评估和综合,这些服务是急诊科(ED)为经历心理健康危机的人提供支持的替代方案。本范围界定综述探讨了这些服务的特点和结果:方法:我们进行了一次系统性的范围界定综述,以确定描述以人为本的危机支持服务及其成果的出版物。在多个数据库中使用了搜索字符串,并对出版物进行了质量评估。综述过程参考了乔安娜-布里格斯研究所(JBI)的《证据综合手册》和《系统综述和Meta分析扩展范围综述的首选报告项目》(PRISMA-ScR):13 篇出版物被纳入了叙述性综述,其中考虑了 8 种不同的危机支持服务。所纳入出版物的方法质量有限。主要研究结果包括来访者的积极体验、急诊室转诊率高以及重复来访、危机预防和避免住院之间的重叠。主要建议包括增加开放时间和容量,提高服务意识和可及性:现有证据表明,以人为本的危机支持服务在利益相关者看来是安全有效的,可以替代急诊室,为遭遇心理健康危机的人提供更及时、更适当的护理,同时减少急诊室的心理健康就诊率。由于收录的出版物质量有限,因此需要进行高质量的研究,以更好地了解该模式并证实本综述中报告的结果。
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来源期刊
CiteScore
8.50
自引率
2.30%
发文量
184
审稿时长
3-6 weeks
期刊介绍: Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.
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