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Cited by 29Psychiatric care and mental health servicesHomelessness and Social IssuesHistorical Psychiatry and Medical Practices

A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness

Siskind, Dan, Harris, Meredith, Kisely, Steve, Brogan, James, Pirkis, Jane, Crompton, David, Whiteford, Harvey·2013·Australian & New Zealand Journal of Psychiatry
DOI 10.1177/0004867413484369
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Abstract

Objective: There is increasing international evidence that crisis houses can reduce the time spent in acute psychiatric inpatient units for patients with severe and persistent mental illness, at a lower cost and in an environment preferable to patients. We evaluated the Alternatives to Hospitalisation (AtH) program, a crisis house operating in outer suburban Brisbane. Methods: One hundred and ninety-three AtH patients were compared to 371 matched controls admitted to a peer hospital district acute psychiatric unit. Hospitalisations, demographics and illness acuity were compared one year before and after an acute index episode of residential care involving hospital and/or AtH. Hospital bed-days during the index episode were compared between AtH participants and controls. The cost of bed-days averted was compared to the cost of providing the AtH program. Results: AtH participants spent 5.35 fewer days in hospital during the index episode than controls, after adjustment for illness acuity, living conditions, marital status and emergency department (ED) presentations. Per patient cost of averted psychiatric inpatient bed-days, $5948.22, was higher than the per patient cost of providing AtH, $3071.44. AtH participants had higher levels of illness acuity, ED presentations and acute psychiatric admissions than controls in the year after the index episode. Conclusions: For acutely unwell, stably housed patients, able to be managed outside of a secure facility, a crisis house program can reduce acute psychiatric bed-days, providing a cost saving for mental health services.

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Crossref · 10.1177/0004867413484369

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  • Participants who had access to wraparound case management support experienced fewer inpatient admissions than those without this type of support.

    “For example, Siskind et al. (2013) found that participants who had access to wraparound case management support experienced fewer inpatient admissions than those without this type of support.”

    From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Siskind et al. 2013

  • Randomisation methods were adequate because only two controlled studies found significant differences between treatment and control groups at baseline, suggesting low risk of selection bias.

    “Overall, randomisation methods were adequate because only two studies found significant differences between the treatment and control groups at baseline (Gilbert et al. 2012;Siskind et al. 2013), which suggests that the risk of selection bias is low.”

    From Effect of community mental health care programs in Australia: A systematic review (2020) · cites this paper as Siskind et al. 2013

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Authors
Siskind, D., Harris, M., Kisely, S., Brogan, J., Pirkis, J., Crompton, D., & Whiteford, H.
Affiliations
  • The University of Queensland (AU)
  • Griffith University (AU)
  • The University of Melbourne (AU)
ORCID
Venue
Australian & New Zealand Journal of Psychiatry
Publisher
SAGE Publications
Published
2013-04-08
Volume
47
Issue
7
Pages
667-675
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
DOI
10.1177/0004867413484369
OpenAlex
W2132435131
Cited by
29
References
36
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 1 · 2016: 3 · 2015: 2 · 2014: 5 · 2013: 2
FWCI
4.44
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Griffith Research Online (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
severe and persistent mental illness, hospitalization reduction, cost-effectiveness, acute psychiatric admission, emergency department presentation, community mental health services, Brisbane
MeSH terms
Adult, Mental Disorders, Community Mental Health Services, Crisis Intervention, Female, Hospitalization, Humans, Male, Retrospective Studies, Severity of Illness Index, Health Care Costs

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