Crisis intervention in psychogeriatrics: A round‐the‐clock commitment?

The purpose of the study was to ascertain if comparable results could be obtained with a crisis intervention service operating during normal working hours as with a round‐the‐clock service. A follow‐up study, over a period of 3 years, was conducted on a cohort of 70 patients aged 65 years and over who were referred urgently to a Crisis Intervention Team over a 6‐month period. This team operated on a 9–5 basis. Outcome under several headings was compared with outcome in a previously reported 2‐year follow‐up study of a crisis intervention service which operated on a 24 hr basis. This group had comparable age and sex distribution, and similar proportions living alone at referral. Diagnostic groupings were similar and in both groups similar percentages of those referred were admitted (31% of 9–5 group vs 29% other). Notable differences were a greater referral rate in the 24 hr group and significantly greater numbers living in residential accommodation in the 9–5 group. Over the follow‐up period 9% of the 9–5 group were admitted vs 5% other. There was a greater use of community services by the 24 hr group. Mortality was almost identical in both groups. The finding that on many outcome criteria results were as impressive in the service operating during normal working hours as in the round‐the‐clock service has important service implications. However, caution is needed in interpreting the results due to the difficulties of comparing two geographically separate services with varied demographic differences. Suggestions for further analysis of models of service delivery are made.