Ahmed, Haleemah; Bendall, Caroline; Anwar, Faiza; Al-Janabi, Mariam; Wood, Lisa; (2024) A Systematic Review and Narrative Synthesis examining the Facilitators and Barriers of Psychological Intervention Delivery in Crisis Resolution Home Treatment Teams. Clinical Psychology & Psychotherapy , 32 (4) , Article e3032. 10.1002/cpp.3032.

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Abstract

Background: Mental health crisis rates in the United Kingdom are on the rise. The emergence of community mental healthmodels, such as Crisis Resolution Home Treatment Teams (CRHTTs), offers a vital pathway to provide intensive assessment andtreatment to individuals in their homes, including psychological interventions. Previous qualitative literature has identified fa-cilitators and barriers to the implementation of psychological interventions within CRHTT settings; however, a synthesis of thisliterature has not yet been conducted. To address this gap, a systematic review was undertaken with the aim of identifying thereported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs.Method: A systematic review and narrative synthesis were conducted. Studies were included if they examined the implemen-tation of evidence-based psychological interventions in a CRHTT setting. The study population had to be 18 and over and couldinclude healthcare professionals working in CRHTTs, service users of CRHTTs, or family and carers of CRHTT service users.Studies of any formal research methodology were included. Four databases were searched (MEDLINE, CINAHL Plus, Embaseand PsycINFO), along with Google Scholar, to identify eligible studies.Results: Six studies were identified, using mixed qualitative and quantitative methodologies, with the predominant focus beingthe exploration of stakeholder perspectives on care implementation within CRHTTs, encompassing aspects including but notrestricted to psychological care implementation. The literature was deemed to be of moderate to high quality. Facilitators in-cluded adapting psychological therapies, prioritizing the therapeutic relationship, increasing psychological skills and training ofCRHTT staff and psychologically informed CRHTT models. The barriers identified included a medical model bias within teams,resource constraints and elements pertaining to CRHTT services.Conclusions: Further robust research in this area is imperative. We recommend that future research be implemented in theform of service evaluations and randomized controlled trials (RCTs) and that the principles of implementation science be used toassess and develop the evidence base for psychological intervention delivery in CRHTTs.

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