Book Review: Crisis Services and Hospital Services: Mental Health at a Turning Point
| Pages | 30-30 |
| Date | 01 June 2000 |
| DOI | https://doi.org/10.1108/13619322200000018 |
| Published date | 01 June 2000 |
| Author | Karen Newbigging |
| Subject Matter | Health & social care |
30 The Mental Health Review Volume 5 Issue 2 June 2000 ©Pavilion Publishing (Brighton) 2000
he publication of this collection
seems timely given the context of the National
Service Framework and the increasing emphasis on
improved access to help and crisis services. The
collection captures the complexity of crisis services
and attempts to clarify definitions, conceptual issues
and models.
It starts with an overview of definitions
of crises and crisis services and moves on to an
introduction to crisis intervention and theory. David
Pilgrim draws attention to the issues of care and
control in mental health policy, which is exemplified
by crisis services, and outlines the context for crisis
services. The scene set there follows a number of
descriptions of crisis services: the Wokingham MIND
Crisis House; the Liverpool Mental Health Crisis
Service and the West Birmingham Home Treatment
Service. There is an over-view of the effectiveness of
crisis services, the role of CPNs and developments in
accident and emergency departments. Shulamit
Ramon provides a helpful summary of exemplary
crisis services in Europe and the USA and Dylan
Tomlinson concludes by drawing the collection
together and mapping out the signposts for the future.
This collection is fairly short with chapters of
manageable length and therefore relatively accessible
to clinicians, managers and commissioners with
significant demands on their time, such as the
implementation of the National Service Framework!
Whether this collection will help them with the task is
debatable. Undoubtedly it does provide a basic intro-
duction to both conceptual issues and some real-life
examples. It would, however, benefit from an
overview linking these together and connecting them
to the current policy agenda. It does not speak of the
issues that many localities are currently facing in
considering the current development of crisis services.
For example:
■What should responses to crises look like in our
locality?
■How will it be integrated with other elements of
the service to provide a comprehensive response to
people in distress?
T
Book Review
Crisis Services and Hospital Services:
Mental Health at a Turning Point
By Dylan Tomlinson and Keith Allen (eds)
(1999) Aldershot: Ashgate
■Should it be provided separately or as part of
existing mental health services?
■How will it link with other crisis responses; for
example, primary care, NHS Direct or social
services?
■How can crisis services provide a response which is
appropriate both to the needs of the individual and
which takes account of gender and ethnicity?
■How can a crisis response be provided in rural
areas with large geographical distances to cover?
■What are the most cost-effective services?
These questions needed to be addressed at a local
level and Dylan Tomlinson is right to draw attention
to the need to establish a developmental process
which aims to clarify the function of local services in
responding to crises and harnesses the commitment
and views of local players. In doing so this collection
will provide some food for thought. It captures the
complexity of the task and ‘the awe inspiring breadth
of concerns which crisis services by their nature
attempt to address’.
The conclusion that Dylan Tomlinson reaches,
however, in the final chapter is not uncontroversial.
He argues in favour of closer collaboration between
hospital psychiatry and crisis services. He suggests
that crisis services are unlikely to survive in a political
climate where risk to the community is the major
driver for policy. This would appear to be a response
to the policy emphasis on safety, both of the individual
and of the community. However, the National Service
Framework is not so circumspect in its approach and
creates a real opportunity for changing the response
and the relationship between services and people with
mental health problems in distress. This collection
will provide limited assistance with this task but may
be of more help to those wanting an introduction to
the debate about crisis services.
Karen Newbigging
Service Development Consultant
NW Mental Health Development Centre
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