Project Management ‐ or Be Prepared! The Development of Crisis Resolution and Home Treatment
| Date | 01 March 2006 |
| Published date | 01 March 2006 |
| Pages | 4-7 |
| DOI | https://doi.org/10.1108/13619322200600002 |
| Author | Peter Walmsley |
| Subject Matter | Health & social care |
Project Management – or Be
Prepared! The Development
of Crisis Resolution and
Home Treatment
Peter Walmsley
CRHT, Project Manager
Mersey Care NHS Trust
Personal Perspective
roject management can be a tough
role but how do you run, on a day-to-day basis, a £5
million crisis resolution and home treatment (CRHT)
project that takes in 10 community mental health
teams, two boroughs, five primary care teams, one
European city of culture, 220 inpatient beds serving
an adult population of 541,000 and startto make an
impact on bed occupancy,staff recruitment, quality
home treatment, service user involvement, and the
immeasurable change of culture?
The Department of Health clearly sets out its
model for CRHT within the Policy Implementation
Guide (2002) – a prescriptive cocktail of hours of home
treatment with suggestions on everything from
practical help to crisis plans to medication
management. But when you have an area covering a
population of over half a million, just whereis the
starting place?
I recall supporting nursing students through
assignment writing who had similar perplexities. ‘Just
where do I start?’ they would enquire. ‘Well,’ I would
reply, ‘a good structure has a beginning, a middle and
an end.’ But as well as structure, the ideas, the art, the
detail are also needed and I love the detail. Where
would we be without it? The ‘detail is in the small
print’ we hear,but it’strue! Without the small print
there is no project.
The small print was how to make home treatment
effective. As an alternative to hospital admission it is a
laudable goal. Or is it? Talking with service users and
carers it is clear that admission is often the saviour of
the crisis. So exhausted is the carer that they plead for
Padmission. This is the starting point then: home
treatment is not for everyone. For some, however, a
real difference can be made. For those newly
diagnosed with ‘hearing voices’ intensive home
treatment can maintain the individual at home by
putting in place an effective care package based on
need, crisis management and the prevention of future
episodes.
The days of routine midnight admissions via
casualty by a tired house officer must cease. We now
have credible alternatives to inpatient admission
which, when carefully managed around risk
formulation, are able to provide intensive home
treatment 24/7. The intensity of this support can be
up to six hours each day with either one or two staff
members. Compare this with the amount of time staff
spend with individual service users in a ward.
Iknow this, but how can over 100 stakeholders be
informed and become a partof CRHT? How can
positive messages be put across which begin the
process of change? One way was to hold a conference
on CRHT with colleagues from Newcastle who had
CRHT up and running. The project manager,with
secretarial assistance, was responsible for organising
this conference. For those of you new to this area, it is
essential to gain the assistance of a good PA. The
commitment was noteworthy, with 120 bookings and
everyseat taken on the day.
So the home treatment philosophy broadens out
with the delivery of other services at home – for
instance, medication management, doctors conducting
domiciliary reviews, psychologists performing home
therapy etc. Sounds good so far and, you might think,
not too difficult to manage. The truth is it wouldn’tbe
4The Mental Health Review Volume 11 Issue 1 March 2006 ©Pavilion Publishing (Brighton) 2006
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