Residential alternatives to acute psychiatric hospital admission: systematic review
Open accessAbstract
Background: Reducing use of hospital wards and improving their quality are central aims of mental health service policy. However, no comprehensive synthesis is available of evidence on residential alternatives to standard acute psychiatric wards. Aims: To assess the effectiveness and cost-effectiveness of and satisfaction with residential alternatives to standard acute in-patient mental health services. Method: A systematic search identified controlled studies comparing residential alternatives with standard in-patient services. Studies were described and assessed for methodological quality. Results from higher quality studies are presented and discussed. Results: Twenty-seven relevant studies were identified. Nine studies of moderate quality provide no contraindication to identified alternative service models and limited preliminary evidence that community-based alternatives may be cheaper and individuals more satisfied than in standard acute wards. Conclusions: More research is needed to establish the effectiveness of service models and target populations for residential alternatives to standard acute wards. Community-based residential crisis services may provide a feasible and acceptable alternative to hospital admission for some people with acute mental illness.
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- Authors
- Lloyd-Evans, B., Slade, M., Jagielska, D., & Johnson, S.
- Affiliations
- King's College London (GB)
- University College London (GB)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-08
- Volume
- 195
- Issue
- 2
- Pages
- 109-117
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2137295023
- Cited by
- 94
- References
- 64
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 12 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 5 · 2018: 4 · 2017: 7 · 2016: 3 · 2014: 8 · 2013: 6 · 2012: 6
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- Service Delivery and Organisation Programme
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- acute mental illness, deinstitutionalization, cost-effectiveness, patient satisfaction
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Mental Disorders, Community Mental Health Centers, Cost-Benefit Analysis, Delivery of Health Care, Hospitalization, Humans, Middle Aged, Time Factors, Randomized Controlled Trials as Topic, Databases, Bibliographic, Patient Satisfaction, Young Adult
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