The Audit Commission report on Accident and Emergency Services dating back to 1996 stated that service users received poor first point of contact care59.
The interface between crisis services and emergency services and the role that emergency services such as the police and Accident and Emergency units play in supporting people in crisis and their transition to more specialised support is critical. Police officers in the US have been trained in crisis intervention skills52 53.
A comparative study of a psychiatric emergency service with the usual consultant support to emergency departments found that this was beneficial to service users presenting with a psychiatric emergency by providing timely rendering of care, improving access to care and ensuring safety and better assessment60.
A recent pilot project in Hertfordshire used rapid assessment, treatment and discharge approach as an alternative to usual in-patient care. Taking average length of stay, catchment area bed overspill, percentage of bed occupancy and number of readmissions within 28 days as outcome indicators the results found that patients who were supported by the RAD team experienced decreased lengths of stay in hospital compared with the control group, with no adverse impact on readmission rates61.