Sir: The survey by Owen et al (Reference Owen, Sashidharan and Edwards2000) exemplifies the difficulties involved in researching home treatment teams, because of the multiplicity of definitions and wide nomenclature for services serving similar functions. Such diversity cannot be assessed adequately using a short survey and broad definition of the subject matter.
The definition of home treatment in the paper is much briefer than the broad definition in the questionnaire and the questionnaire refers to “access to community staff on a 24 hour basis”, whereas the paper reports on “availability on a 24-hour basis”. Such inconsistencies may give rise to inaccurate representations of what was surveyed. Furthermore, the questionnaire is internally inconsistent in referring to home treatment services both as an alternative to hospital admission and as a supplement to hospital-based services, which does not help identify the kinds of service being examined.
A similar but much more extensive recent (1998) survey (Reference Orme and BrimblecombeOrme, 2000) of nationwide crisis services found a wider penetration of services. Of 152 selfdefined crisis services, 22 were identified as home treatment services offering an alternative to admission. Of these, eight offered a 24-hour service (seven of which were available only on an on-call basis out of office hours) and eight were staffed by nurses only.
Owen et al report high expectations for new developments in home treatment. However, during the period of data collection regarding crisis services, 10% ceased operating or were being considered for closure. Will home treatment services go the same way?
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