Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition.

To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0–17 years) presenting with an acute mental health condition.

A systematic literature search was conducted, and the studies’ methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022.

We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent–child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects.

This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.

Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services.

We aimed to synthesise the relevant qualitative literature.

Five databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis.

Eleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support.

Our findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed.

This study aimed to assess the published literature on non-technical skills in otolaryngology surgery and examine the applicability of any research to others’ practice, and to explore how the published literature can identify areas for further development and guide future research.

A systematic review was conducted using the following key words: ‘otolaryngology’, ‘otorhinolaryngology’, ‘ENT’, ‘ENT surgery’, ‘ear, nose and throat surgery’, ‘head and neck surgery’, ‘thyroid surgery’, ‘parathyroid surgery’, ‘otology’, ‘rhinology’, ‘laryngology’ ‘skull base surgery’, ‘airway surgery’, ‘non-technical skills’, ‘non technical skills for surgeons’, ‘NOTSS’, ‘behavioural markers’ and ‘behavioural assessment tool’.

Three publications were included in the review – 1 randomised, controlled trial and 2 cohort studies – involving 78 participants. All were simulation-based studies involving training otolaryngology surgeons.

Little research has been undertaken on non-technical skills in otolaryngology. Training surgeons’ non-technical skill levels are similar across every tested aspect. The research already performed can guide further studies, particularly amongst non-training otolaryngology surgeons and in both emergency and elective non-simulated environments.

This is a naturalistic study comparing the outcomes of all emergency psychiatric interventions in the Hospital Center of Luxemburg during two periods of six months each, before and after the introduction of a crisis intervention program. The aim of the study was to investigate the clinical and economic impact of crisis intervention on psychiatric emergency admissions.

All subjects admitted to the emergency psychiatric unit during the two study periods were considered for participation. Data were collected retrospectively and comparisons were made between patients before (September 1, 2001 to February 28, 2002) and after (September 1, 2002 to February 28, 2003) crisis intervention programs were established.

A comparison between the two patient groups demonstrated a significant decrease in the rate of voluntary hospitalizations after crisis intervention, and a significant increase in the number of patients with subsequent outpatient consultations. The cost increase due to ambulatory follow-ups was widely compensated for by the cost decrease due to hospitalization avoidance.

These preliminary findings suggest that crisis intervention leads to a shift from hospitalization to outpatient psychotherapeutic management in emergency psychiatric services, which has a significant economic impact.

To describe an innovative model of emergency intervention with patients enduring severe stalking.

Catamnestic investigation of the institutional, psychopathological, clinical, legal and therapeutic aspects of severe stalking syndromes among 20 patients referred to emergency room with severe stalking syndromes.

A well structured model of multimodal psychiatric intervention is described and its results.

Comment: Severe stalking is a common issue in emergency psychiatry. These patients should be better detected and may benefit from the adequate psychiatric treatment. Further studies should investigate this innovative intervention in randomized clinical trials.

We aimed to reduce the gap between clinicians and researchers by showing how a qualitative method may reveal experiences about how professionals explained their clinical practice in crisis intervention and what their representation are of people in crisis.

In depth, semi-structured interviews were conducted, transcribed and independently reviewed by using Grounded Theory Methodology (GTM). Data were analyzed with the constant comparative method. The study was conducted in crisis experts in Psychiatric Emergency Room (PER). A purposive sample of 17 professionals in crisis intervention included in our study.

Results showed that therapeutic processes are managed in multiple interactions and regulations. Crisis intervention is an opportunity to highlight the psychic functioning. There are multiple settings of interventions oriented by the context of the institution and theorical background of professionals. The social realities slow down the possibility to elaborate the end of the intervention.

This study illuminates that clinicians and professionals in crisis intervention need guidelines to better improve their therapeutic interventions. They also need a political support to create specialized training and develop medical and psychological services to take in charge people in crisis. This research contributes to show the discrepancy between what the professional thinks to do in their interventions and what he really do.

The Crisis Intervention Team (CIT) model is a law enforcement strategy that aims to build alliances between the law enforcement and mental health communities. Despite its success in the United States, CIT has not been used in low- and middle-income countries. This study assesses the immediate and 9-month outcomes of CIT training on trainee knowledge and attitudes.

Twenty-two CIT trainees (14 law enforcement officers and eight mental health clinicians) were evaluated using pre-developed measures assessing knowledge and attitudes related to mental illness. Evaluations were conducted prior to, immediately after, and 9 months post training.

The CIT training produced improvements both immediately and 9 months post training in knowledge and attitudes, suggesting that CIT can benefit law enforcement officers even in extremely low-resource settings with limited specialized mental health service infrastructure.

These findings support further exploration of the benefits of CIT in highly under-resourced settings.

Suicide Prevention is an ongoing task for mental health services. This article describes a pilot program for suicide prevention that took place in two districts in Israel from 2009 to 2012. The program targeted specific population, patients in high-risk for suicide, without major mental illness or previous association with the mental health system. In that group many suicide attempts were due to stressful life events.

Patients who performed a suicide attempt or were considered high-risk for suicide were referred to the project. The first contact took place up to 24 h after the referral and included a phone call with suggestion for further intervention. If he was willing, the patient was invited to a serious of 8–12 meetings with a therapist that focused on “crisis intervention” techniques.

212 subjects were referred to the project. Three quarters of the referrals were females. Most of them were of Jewish nationality, however, the percentage of Druze in the program’s population was higher than their percentage of general population. Only 137 continued participation after the initial phone call, people of Jewish nationality were more willing to continue the intervention. During the intervention there was a decline in suicide rates in the participating districts.

The pilot program exhibits promising preliminary results, it is interesting to examine the difference in participation between different ethnic groups. Since the sample size is small, there is a need to continue the program on a larger scale.

The most common crisis intervention used with German rescue workers is Critical Incident Stress Management (CISM). Results regarding its effectiveness are inconsistent. A negative reinforcement of avoidance, due to premature termination of strong emotions during the Critical Incident Stress Debriefing (CISD), may explain this. The effectiveness of the CISD after terror attacks in Germany has not yet been investigated.

All emergency responders deployed at the terror attack on Breitscheidplatz in Berlin were invited to take part in the study; 37 of the N = 55 participants had voluntarily participated in CISD; 18 had not.

Participants with CISD showed lower quality of life in psychological health and higher depressive symptomatology. Of these, females had lower quality of life in social relationships, whereas males showed more posttraumatic stress symptoms. Emergency responders from non-governmental organizations had higher phobic anxiety. Emergency medical technicians showed more somatic and depressive symptoms.

There is no conclusive explanation for why rescue workers with CISD score worse on certain measures. It is possible that CISD has a harmful influence due to negative reinforcement, or that there was a selection effect. Further research differentiating occupational group, sex, and type of event is necessary.

Street triage services are increasingly common and part of standard responses to mental health crises in the community, but little is understood about them. We conducted a national survey of mental health trusts to gather detailed information regarding street triage services alongside a survey of Thames Valley police officers to ascertain their views and experiences.

Triage services are available in most areas of the country and are growing in scope. There is wide variation in levels of funding and modes of operation, including hours covered. Police officers from our survey overwhelmingly support such services and would like to see them expanded.

Mental health crises now form a core part of policing and there are compelling reasons for the support of specialist services. Recent changes to the law have heightened this need, with a requirement for specialist input before a Section 136 is enacted. Those who have experienced triage services report it as less stigmatising and traumatic than a traditional approach, but there remains little evidence on which to base decisions.

None.

The purpose of this study was to investigate potential association between psychopathology and subjective evaluation of the experience of debriefing in disaster-exposed rescue and recovery workers.

Structured diagnostic interviews for DSM-III-R psychiatric disorders were conducted with 166 firefighters who served as rescue and recovery workers for the 1995 Oklahoma City bombing, who categorized their satisfaction with the debriefing on 4 levels. “Very dissatisfied” responses were examined for their association with post-traumatic stress disorder (PTSD) and with PTSD symptom groups.

Being “very dissatisfied” with the debriefing was significantly associated with the DSM-III-R avoidance and numbing group and with PTSD.

These findings suggest that debriefing may be an unsatisfactory intervention for people with prominent avoidance and numbing symptoms, such as those with PTSD. These individuals might be better served by referral directly to psychiatric treatment (Disaster Med Public Health Preparedness. 2018;12:718-722).

Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base.

A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PILOTS, PubMed, and PsycINFO) was conducted in the spring of 2014 using search terms related to psychological debriefing. The search was limited to English language sources and studies of youth, aged 0 to 18 years. No time limit was placed on date of publication. The search yielded 713 references. Titles and abstracts were reviewed to select publications describing scientific studies and clinical reports. Reference sections of these publications, and of other literature known to the authors that was not generated by the search, were used to locate additional materials. Review of these materials generated 187 publications for more thorough examination; this assessment yielded a total of 91 references on debriefing in children and adolescents. Only 15 publications on debriefing in children and adolescents described empirical studies. Due to a lack of statistical analysis of effectiveness data with youth, and some articles describing the same study, only seven empirical studies described in nine papers were identified for analysis for this review. These studies were evaluated using criteria for assessment of methodological rigor in debriefing studies.

Children and adolescents included in the seven empirical debriefing studies were survivors of motor-vehicle accidents, a maritime disaster, hostage taking, war, or peer suicides. The nine papers describing the seven studies were characterized by inconsistency in describing the interventions and populations and by a lack of information on intervention fidelity. Few of the studies used randomized design or blinded assessment. The results described in the reviewed studies were mixed in regard to debriefing’s effect on posttraumatic stress, depression, anxiety, and other outcomes. Even in studies in which debriefing appeared promising, the research was compromised by potentially confounding interventions.

The results highlight the small empirical evidence base for drawing conclusions about the use of debriefing with children and adolescents, and they call for further dialogue regarding challenges in evaluating debriefing and other crisis interventions in children.

PfefferbaumB , JacobsAK , NitiémaP , EverlyGSJr. Child Debriefing: A Review of the Evidence Base. Prehosp Disaster Med. 2015;30(3):1 10.