A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness

Siskind, Dan, Harris, Meredith, Kisely, Steve, Brogan, James, Pirkis, Jane, Crompton, David and Whiteford, Harvey (2013) A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness. Australian and New Zealand Journal of Psychiatry, 47 7: 667-675. doi:10.1177/0004867413484369


Author Siskind, Dan
Harris, Meredith
Kisely, Steve
Brogan, James
Pirkis, Jane
Crompton, David
Whiteford, Harvey
Title A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
1440-1614
Publication date 2013-07
Year available 2013
Sub-type Article (original research)
DOI 10.1177/0004867413484369
Volume 47
Issue 7
Start page 667
End page 675
Total pages 9
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2014
Language eng
Formatted abstract
Objective: There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric
inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable
to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban
Brisbane.

Methods: One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer
hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before
and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index
episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the
cost of providing the AtH program.

Results: AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment
for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of
averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH
participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the
year after the index episode.

Conclusions: For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house
program can reduce acute psychiatric bed-days, providing a cost saving for mental health services.
Keyword Mental health
Service evaluation
Hospital
Crisis housing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
School of Medicine Publications
 
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