A study of ‘crisis cards' in a community psychiatric service

Publisher Website
Google Scholar
Abstract
Sutherby K, Szmukler GI, Halpern A, Alexander M, Thornicroft G, Johnson C, Wright S. A study of ‘crisis cards’ in a community psychiatric service. Acta Psychiatr Scand 1999: 100: 56–61. © Munksgaard 1999. Objective: ‘Crisis cards’ state patients' treatment details and preferences in anticipation of a later occasion when the patient might be too ill to express them directly. We assessed the feasibility of introducing ‘crisis cards’, or a collaborative form of them, ‘joint crisis plans’, into a sectorized community psychiatric service. Method All patients with a psychosis and at high risk of crisis were invited to participate. Follow‐up examined patients' satisfaction and how the cards were used. Results: In total, 106 eligible patients were identified and offered a card, and 40% agreed to participate. Patients with an affective psychosis, past suicide attempts and less frequent admissions were over‐represented among those who agreed to take part. Patients chose to include a wide range of information. For participants, admissions fell by 30% in the follow‐up year. Conclusion: Crisis cards serve both a ‘manifest’, practical function (to provide important information when the patient is too ill to do so) and a ‘latent’ psychological one (positive effects on the patient's attitude to self, their illness and treatment, and their relationship with the clinical team).