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Individualisation in crisis planning for people with psychotic disorders

Published online by Cambridge University Press:  10 September 2013

S. Farrelly ,
G. Szmukler ,
C. Henderson ,
M. Birchwood ,
M. Marshall ,
W. Waheed ,
C. Finnecy  and
G. Thornicroft
S. Farrelly*
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
G. Szmukler
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
C. Henderson
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
M. Birchwood
Affiliation:
Department of Psychology, University of Birmingham, Birmingham, UK
M. Marshall
Affiliation:
Division of Psychiatry, School of Medicine, University of Manchester, Manchester, UK
W. Waheed
Affiliation:
Division of Psychiatry, School of Medicine, University of Manchester, Manchester, UK
C. Finnecy
Affiliation:
Department of Psychology, University of Birmingham, Birmingham, UK
G. Thornicroft
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: S. Farrelly, Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigney Park, London SE5 8AF, UK. (Email: simone.farrelly@kcl.ac.uk)
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Abstract

Background.

In England, people with a serious mental illness are offered a standardized care plan under the Care Programme Approach (CPA). A crisis plan is a mandatory part of this standard; however, the quality and in particular the level of individualisation of these crisis plans are unknown. In this context, the aim of this study was to assess the quality of crisis planning and the impact of exposure to a specialized crisis planning intervention.

Method.

The crisis plans of 424 participants were assessed, before and after exposure to the Joint Crisis Plan (JCP) intervention, for ‘individualisation’ (i.e., at least one item of specific and identifiable information about an individual). Associations of individualisation were investigated.

Results.

A total of 15% of crisis plans were individualised at baseline. There was little or no improvement following exposure to the JCP. Individualised crisis plans were not associated with a history of prior crises or incidences of harm to self and others.

Conclusions.

Routine crisis planning for individuals with serious mental illness is not influenced by clinical risk profiles. ‘Top down’ implementation of the policy is unlikely to generate the best practice and compliance if clinicians do not perceive the clinical value in the process.

Keywords

Crisis planningindividualisationmental health carequality indicators
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 23 , Issue 4 , December 2014 , pp. 353 - 359
Copyright
Copyright © Cambridge University Press 2013 

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