FINCH: A crisis planning intervention to reduce compulsory admissions
Research type
Research Study
Full title
Development, Feasibility Testing and Pilot Trial of a Crisis Planning and Monitoring Intervention to Reduce Compulsory Hospital Readmissions (the FINCH Study)
IRAS ID
300671
Contact name
Sonia Johnson
Contact email
Sponsor organisation
UCLH/UCL Joint Research Office
Duration of Study in the UK
3 years, 3 months, 16 days
Research summary
More and more people are being admitted to psychiatric hospitals without consent (compulsorily admitted or “sectioned”). Patients and families often find such admissions distressing, disempowering and traumatising. Ethically, treatment should involve collaboration and consent except when truly unavoidable. Strategies for reducing compulsory admissions are therefore urgently needed.
People who have had at least one compulsory admission are at particularly high risk of future compulsory admissions. We therefore focus on these people in the plan we have developed for reducing compulsory hospital admissions.
Not much relevant research has been done, but the little there is suggests the best approaches involve making a plan for how to respond to a future crisis to avoid someone being “sectioned”. A promising study was carried out in a metropolitan part of Switzerland. Here crisis planning was part of a programme designed to prevent compulsory re-admissions. It included individualised strategies for monitoring for early signs of crisis, and for empowering patients to develop and put into practice crisis prevention plans.
We are currently adapting this strategy to an NHS context, working with experts by profession and experience. It will involve four sessions around the time of hospital discharge with a personal mental health worker (a clinical psychologist or someone equivalently skilled) then monthly phone or video calls.
This application is for us to carry out initial tests of this strategy to reduce sectioning. We will do this mainly by carrying out a small trial of 80 people, in which chance will decide whether people get our new strategy or usual treatment. We will find out whether we can recruit people to take part in a trial, whether they stick with the programme and find it helpful. We will get some idea of whether the programme seems likely to be effective and whether it should be tested in a bigger trial.
REC name
London - Bromley Research Ethics Committee
REC reference
21/LO/0734
Date of REC Opinion
3 Dec 2021
REC opinion
Further Information Favourable Opinion