Person-centred crisis support services as alternatives to emergency departments: a systematic scoping review

To identify, critically appraise, and synthesise the published and grey literature on person-centred crisis support services as an alternative to support in emergency departments (EDs) for people experiencing mental health crises. This scoping review explores the characteristics and outcomes of these services. A systematic scoping review was undertaken to identify publications describing person-centred crisis support services and their outcomes. Search strings were applied to multiple databases, and publications were subjected to quality appraisal. The review process was informed by The Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Thirteen publications were included in the narrative synthesis, and these considered eight separate crisis support services. The methodological quality of the publications included was limited. Key findings were positive visitors' experiences, high rates of ED deflection, and overlaps between repeat visits, crises prevention, and hospital avoidance. Key recommendations included increasing opening hours and capacity and improving service awareness and accessibility. The available evidence suggests that person-centred crisis support services are perceived by stakeholders as safe and effective alternatives to EDs for people experiencing mental health crises, providing more timely and appropriate care while reducing ED mental health presentations. Due to the limited quality of the publications included, high-quality research is needed to better understand the model and confirm the findings reported in this review.