Acute Day Units as Crisis Alternatives to Residential Care AD-CARE

Record ID 32016000923
Authors' objectives: Acute Day Units (ADUs) offer support to people who are experiencing severe mental health difficulties. ADUs are an alternative to a hospital admission, and also support people once they have been discharged from hospital, meaning that they spend less time on a mental health ward. ADUs provide a range of interventions, often in groups, and offer opportunities to combat loneliness, empower service users. We found that 22% of crisis teams had access to an ADU, and they valued them more than other alternatives to hospital care, such as crisis houses. ADUs are recommended in the Crisis Care Concordat, a national agreement between services about the support that should be offered to people. Locally, we have had positive feedback from people who have accessed our ADUs in Camden and Coventry. ADUs probably vary greatly but we know little about them and there is no national guidance about what a good ADU looks like. We need evidence to be able to make recommendations about the best way to provide these services to support people in crisis. Methods We aim to explore people s experiences of ADUs and find out if they are helpful. We will provide a description of ADUs and look at their availability nationally. We will use a mixture of research methods in 3 pieces of work called work packages (WPs). Initially (WP1) we will do a national survey of ADUs and collect information about the numbers of people accessing each ADU, their diagnoses and length of stay. We will describe the main types of ADU, including how service users are referred to, and leave, ADUs, their staff, the types of support they offer, and the level of service user involvement. We will then collect five case studies (WP2) using a mix of different research methods to see if ADUs are helpful and what people most value about them. WP2.1: We will recruit 400 people who receive support from 5 different ADUs across the country and compare them with 400 people from the same area who do not receive ADU care. We will see if people who receive support from an ADU are less likely to be re-admitted to a psychiatric hospital or crisis team compared with those who do not access an ADU (over a period of 6 months). We will also determine if people who get support from an ADU are more satisfied with care after 3 months. WP2.2: We will interview 5 service users, 3 carers and 3 practitioners in each ADU. We will explore people s views of the strengths and weaknesses of ADUs, and their role in supporting people in urgent crisis. In the final stage of the study (WP3) we will use national data about the care of people using mental health services, called the Mental Health Minimum Dataset, to look at patterns of admission to mental health wards and crisis teams in England. We will use statistical techniques to see whether fewer people are re-admitted to hospital in areas with an ADU compared with areas which do not have one. We will bring together this evidence to develop a description of ADUs and recommendations outlining best practice, which can be used to improve the support offered to people in crisis. Our team includes a Service User Research Group, researchers, including a peer researcher (with lived experience of mental health difficulties) and external advisers. Dissemination of our findings will be carefully planned and will include peer review publications, and resources for service users carers and practitioners, including summary documents and a website.
Project Status: Ongoing
Anticipated Publish Date: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Mental Disorders
  • Community Mental Health Centers
  • Residential Facilities
  • Day Care, Medical
  • Crisis Intervention
  • Mental Health Services
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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