Evidence map›Paper›PMID 33736743›Full record

ArticleBJPsych open2021

A comparison of clinical outcomes, service satisfaction and well-being in people using acute day units and crisis resolution teams: cohort study in England.

Danielle Lamb, Thomas Steare, Louise Marston, Alastair Canaway, Sonia Johnson, James B Kirkbride, Brynmor Lloyd-Evans, Nicola Morant, Vanessa Pinfold, Deb Smith and 2 more

Open access · goldAbstract read
In one paragraph

Article in BJPsych open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Danielle LambNIHR ARC North Thames, Department of Applied Health Research, University College London, UK.ORCID https://orcid.org/0000-0003-1526-9793
Thomas SteareDivision of Psychiatry, University College London, UK.ORCID https://orcid.org/0000-0002-3881-2018
Louise MarstonDepartment of Primary Care and Population Health, University College London, UK.
Alastair CanawayClinical Trials Unit, University of Warwick, UK.
Sonia JohnsonDivision of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK.
James B KirkbrideDivision of Psychiatry, University College London, UK.ORCID https://orcid.org/0000-0003-3401-0824
Brynmor Lloyd-EvansDivision of Psychiatry, University College London, UK.ORCID https://orcid.org/0000-0001-9866-788X
Nicola MorantDivision of Psychiatry, University College London, UK.
Vanessa PinfoldMcPin Foundation, UK.
Deb SmithMcPin Foundation, UK.
Scott WeichSchool of Health and Related Research, University of Sheffield, UK.
David P OsbornDivision of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK.ORCID https://orcid.org/0000-0003-2519-1539
University College London · GBMcPin Foundation · GBUniversity of Sheffield · GBUniversity of Warwick · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor people in mental health crisis, acute day units (ADUs) provide daily structured sessions and peer support in non-residential settings, often as an addition or alternative to crisis resolution teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly compared with those receiving CRT care alone.

aimsWe aimed to investigate readmission rates, satisfaction and well-being outcomes for people using ADUs and CRTs.

methodWe conducted a cohort study comparing readmission to acute mental healthcare during a 6-month period for ADU and CRT participants. Secondary outcomes included satisfaction (Client Satisfaction Questionnaire), well-being (Short Warwick-Edinburgh Mental Well-being Scale) and depression (Center for Epidemiologic Studies Depression Scale).

resultsWe recruited 744 participants (ADU: n = 431, 58%; CRT: n = 312, 42%) across four National Health Service trusts/health regions. There was no statistically significant overall difference in readmissions: 21% of ADU participants and 23% of CRT participants were readmitted over 6 months (adjusted hazard ratio 0.78, 95% CI 0.54-1.14). However, readmission results varied substantially by setting. At follow-up, ADU participants had significantly higher Client Satisfaction Questionnaire scores (2.5, 95% CI 1.4-3.5, P < 0.001) and well-being scores (1.3, 95% CI 0.4-2.1, P = 0.004), and lower depression scores (-1.7, 95% CI -2.7 to -0.8, P < 0.001), than CRT participants.

conclusionsPatients who accessed ADUs demonstrated better outcomes for satisfaction, well-being and depression, and no significant differences in risk of readmission, compared with those who only used CRTs. Given the positive outcomes for patients, and the fact that ADUs are inconsistently provided in the National Health Service, their value and place in the acute care pathway needs further consideration and research.

Indexed as

Community mental health teamsepidemiologyout-patient treatmentpsychiatric nursing

Identifiers

PMID33736743
PMCPMC8058818
OpenAlexW3136136221

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.