CRIMSON Study: RCT of Joint Crisis Plans to Reduce Compulsory Treatment of People with Psychosis

背景：英国的精神卫生政策强调，服务使用者应该行使选择权，并以最少限制的方式接受治疗。尽管如此，根据《精神卫生法》强制入院的情况继续增加。联合危机计划（JCP）是迄今为止唯一被证明可以减少强制治疗的结构性干预措施。它旨在增强保持器持有人的能力，并帮助及早发现和治疗精神病复发。研究设计：一项多中心随机对照试验，将联合危机计划与有复发性精神病史的人的常规治疗进行比较。干预：JCP是由心理健康服务用户与工作人员和独立的促进者合作开发的。该计划包含的信息包括复发的早期预警信号，药物和治疗偏好的细节。评估的结局：（一）在后续行动期间根据《精神卫生法》的命令接受或拘留的服务使用者比例;（二）费用;（三）感觉到的胁迫。(iv)参与精神卫生服务;（五）治疗关系;（六）减少黑人服务使用者对《精神卫生法》的使用。

Background: Mental health policy in England emphasises that service users should exercise choice and be treated in the least restrictive way. Despite this, use of compulsory admissions under the Mental Health Act continues to rise. The Joint Crisis Plan (JCP) is so far the only structured intervention shown to reduce compulsory treatment. It aims to empower the holder and to help early detection and treatment of relapse of mental illness. Study design: A multi-site randomised controlled trial of Joint Crisis Plans compared with treatment as usual for people with a history of relapsing psychotic illness. The intervention: The JCP is developed by a mental health service user in collaboration with staff and an independent facilitator. The plan contains information including early warning signs of relapse, details of medication and treatment preferences. Outcomes assessed: (i) Proportion of service users admitted or detained under an order of the Mental Health Act during the follow-up period; (ii) Costs; (iii) Perceived coercion. (iv) Engagement with mental health services; (v) Therapeutic relationship; and (vi) reduced use of the Mental Health Act for the black service users.