Evaluating Mental Health Decision Units in acute care pathways
Research type
Research Study
Full title
Evaluating Mental Health Decision Units in Acute Care Pathways (DECISION): A quasi-experimental and health economic evaluation
IRAS ID
256406
Contact name
Steve Gillard
Contact email
Sponsor organisation
St George's, University of London
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Many people experiencing a mental health crisis go to A&E and wait a long time for assessment. They may be admitted to a psychiatric ward unnecessarily because of lack of proper assessment. People not signposted to the most appropriate aftercare might repeatedly attend A&E and be admitted to hospital.
New Mental Health Decision Units (MHDUs) are designed to address this. MHDUs are short stay units with a high staff:patient ratio delivering in-depth assessment of individual support, aiming to reduce unnecessary hospital admissions and attendance at A&E, and to improve experiences of crisis care. This study evaluates the impact of MHDUs: whether they save money and how they best operate.
We will study four new MHDUs in England in detail. Using anonomysed data, we will analyse weekly information about all mental health-related A&E attendance and admission to psychiatric hospital for each Trust for two years before and two years after opening the MHDU. This will show the extent to which it is the introduction of MHDUs that impacts on service use and cost. To find out if MHDUs benefit all people equally, we will use individual information (age, gender, ethnicity, diagnosis) about all people admitted to MHDUs in the 9 months before and year after admission to the unit. We will conduct in-depth interviews about experiences of care, assessment and aftercare with 30 people following their stay on an MHDU and 9 months later. This will inform a set of typical ‘pathway stories’ or scenarios about the potential costs and benefits of MHDUs, for different groups of people, and where units have different referral criteria. To find out if MHDUs work as they were designed or if other organisational pressures impact on outcomes, we will interview both MHDU staff and staff who make referrals to MHDUs.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
19/EM/0226
Date of REC Opinion
14 Aug 2019
REC opinion
Further Information Favourable Opinion