Over the past three decades mental health care of people in crisis has moved from predominantly hospital-based to being largely community based. We sought evidence for the effectiveness of a specific home-care package for people in crisis; crisis intervention. It was difficult to find trials specifically randomising crisis intervention with hospital care as all crisis interventions were coupled with a broader home-based package. Overall, nearly half of the people in crisis allocated to home care eventually needed to be admitted to hospital. The crisis/home care package, however, may help avoid repeat admissions (although data are not strong and are overly influenced by one very positive study).
Crisis/home care does reduce the number of people leaving the study early and the burden on the family. It also seems to be a more satisfactory form of care for both people with severe mental illnesses and their families and may be less expensive than standard care. Several reports specifically mentioned that the burden on the teams was considerable and that the crisis/home care does not clearly affect a person's mental state. Management of a crisis at home is now widely incorporated into other care packages. More data from existing studies may help clarify if this is a prudent use of resources.