Evaluating the effectiveness of the functional pathway in an older people’s crisis team

Crisis Resolution and Home Treatment Teams are an important part of modern mental health services; however many regions across the UK continue to operate generic crisis teams across all age groups. Older adult mental health often comes with complexities and co-morbidities; specialist knowledge in this age group is beneficial for effective support. The Crisis Intervention Team for Older People (CITOP) operates as a community-based service across Hull and the East Riding of Yorkshire, using a psychosocial model to support older adults in crisis. This service evaluation examined whether the functional pathway within CITOP was associated with reduced inpatient admissions, improvements in psychological wellbeing, and delivering compassionate patient care. A naturalistic observational design was used, using routinely collected clinical data. Aims were reviewed using discharge destination data, Recovering Quality of Life Questionnaire-10 (ReQol-10) scores at the point of referral and discharge, and patient responses to the Friends and Family Test (FFT). Of the 78 functional referrals included, 88.5% were discharged to CMHTs or primary care, and 11.5% were admitted to an inpatient unit. Paired ReQol-10 data were available for 21 service users, showing a median increase from 12 at referral to 20 at discharge. This difference was statistically significant (Wilcoxon signed-rank test), Z=−3.72, p<.05, with a large effect size (r=.81). Responses on the FFT implied that CITOP was respectful of patient-centred values, provided positive emotional support, and a good level of information and education. Taken together, these findings suggest that CITOP provides an essential specialist crisis service for older adults with potential benefits in reducing admissions, improving psychological wellbeing, and delivering compassionate and person-centred care. While this is a preliminary evaluation, limited by a small sample size and incomplete outcome data, it offers a foundation for future, larger-scale studies.