Addressing acute mental health crises

Background: Mental health crises can involve a number of circumstances, including suicidality and aggression to others. Such crises often result in young people and their families turning to hospital emergency rooms for support. Methods: We used systematic review methods to identify studies evaluating alternatives to inpatient mental health care for children in crises. Applying our inclusion criteria, we accepted two randomized controlled trials. Results: Both Home-Based Crisis Intervention and Multisystemic Therapy (MST) aimed to avert hospitalization for young people in crisis by providing intensive community-based treatments. Both programs were associated with important gains. Home-Based Crisis Intervention reduced children’s emotional problems and overall problems at post-test. MST reduced days in hospital and behavioural problems at post-test. As well, a one year follow-up, MST youth also had significantly fewer suicide attempts.Conclusions: Community based treatments, such as MST and Home-Based Crisis Intervention, can effectively treat young people experiencing mental health crises. These treatments can also result in better short-term outcomes than hospitalization.