{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:33:34Z","timestamp":1791254014864,"version":"4.1.0"},"reference-count":31,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T00:00:00Z","timestamp":1560384000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec id=\"S2056472419000280_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental health services lack a strong evidence base on the most effective interventions to reduce compulsory admissions. However, some research suggests a positive impact of crisis-planning interventions in which patients are involved in planning for their future care during a mental health crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472419000280_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This review aimed to synthesise randomised controlled trial (RCT) evidence on the effectiveness of crisis-planning interventions (for example advance statements and joint crisis plans) in reducing rates of compulsory hospital admissions for people with psychotic illness or bipolar disorder, compared with usual care (PROSPERO registration number: CRD42018084808).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472419000280_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Six online databases were searched in October 2018. The primary outcome was compulsory psychiatric admissions and secondary outcomes included other psychiatric admissions, therapeutic alliance, perceived coercion and cost-effectiveness. Bias was assessed using the Cochrane collaboration tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472419000280_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The search identified 1428 studies and 5 RCTs were eligible. One study had high risk of bias because of incomplete primary outcome data. Random-effects meta-analysis showed a 25% reduction in compulsory admissions for those receiving crisis-planning interventions compared with usual care (risk ratio 0.75, 95% CI 0.61\u20130.93,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.008; from five studies). There was no statistical evidence that the intervention reduced the risk of voluntary or combined voluntary and compulsory psychiatric admissions. Few studies assessed other secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472419000280_sec_a5\" sec-type=\"conclusion\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our meta-analysis suggests that crisis-planning interventions substantially reduce the risk of compulsory admissions among individuals with psychotic illness or bipolar disorder. Despite common components, interventions varied in their content and intensity across the trials. The optimal models and implementation of these interventions require further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472419000280_sec_a6\">\n                    <jats:title>Declaration of interest<\/jats:title>\n                    <jats:p>E.M., S.L., S.J. and B.L.-E. received funding from the National Institute for Health Research during the conduct of the study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2019.28","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T09:16:45Z","timestamp":1560417405000},"source":"Crossref","is-referenced-by-count":86,"title":["Crisis-planning interventions for people with psychotic illness or bipolar disorder: systematic review and meta-analyses"],"prefix":"10.1192","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-5511","authenticated-orcid":false,"given":"Emma","family":"Molyneaux","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Candy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Landau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9866-788X","authenticated-orcid":false,"given":"Brynmor","family":"Lloyd-Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2019,6,13]]},"reference":[{"key":"S2056472419000280_ref29","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.117762"},{"key":"S2056472419000280_ref27","article-title":"Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: economic outcomes","volume":"11","author":"Barrett","year":"2013","journal-title":"PLoS One"},{"key":"S2056472419000280_ref26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38929.653704.55"},{"key":"S2056472419000280_ref31","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.188.4.386"},{"key":"S2056472419000280_ref25","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2015.00161"},{"key":"S2056472419000280_ref24","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 5.20 (updated June 2017)","author":"Deeks","year":"2017"},{"key":"S2056472419000280_ref23","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.6.513"},{"key":"S2056472419000280_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-7-52"},{"key":"S2056472419000280_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38155.585046.63"},{"key":"S2056472419000280_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700037740"},{"key":"S2056472419000280_ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0091882"},{"key":"S2056472419000280_ref5","doi-asserted-by":"publisher","DOI":"10.1176\/ps.62.5.pss6205_0471"},{"key":"S2056472419000280_ref15","volume-title":"Advance Directives (Living Wills) \u2013 Scotland","year":"2016"},{"key":"S2056472419000280_ref9","unstructured":"Department of Health and Social Care. Moderninsing the Mental Health Act. Increasing Choice, Reducing Compulsion. Department of Health and Social Care, 2018."},{"key":"S2056472419000280_ref30","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.182.2.105"},{"key":"S2056472419000280_ref1","volume-title":"Inpatients Formally Detained in Hospitals Under the Mental Health Act 1983, and Patients Subject to Supervised Community Treatment. 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