The influence of crisis resolution treatment on employment: a retrospective register-based comparative study

Abstract

Crisis resolution treatment (CRT) is a short-term acute psychiatric home-based treatment offered as an alternative to hospitalization. The purpose of CRT is to support patient recovery by maintaining and improving competencies in relation to everyday life. Individuals with mental disorders are at increased risk of leaving the labor market, which is a central aspect of everyday life. Thus, a primary outcome of interest is whether CRT enables higher employment compared with traditional hospitalization. The aim of this study was to assess the effectiveness of CRT compared with hospitalization in relation to attempted or committed suicides, admissions, readmissions and employment. This study utilized register-based psychiatric data. The CRT intervention, which was carried out in a psychiatric center (N = 374), was matched to traditional hospitalization treatment in a corresponding area (N = 9460). The outcomes (suicide attempts, suicides, admissions and readmissions) were replicated by applying propensity score matching (PSM) to evaluate the general treatment effect of CRT. The effectiveness of CRT on employment was estimated by applying PSM combined with a difference-in-difference estimator to account for any time trends. Receiving CRT was associated with significantly more employment after 1 year compared with hospitalization. Furthermore, after 1 year, receiving CRT was associated with fewer suicide attempts, admissions and readmissions. The associations were not significant after two years. The results suggest that CRT patients retain a higher employment rate, which could indicate better recovery. Using CRT could lead to savings in the social security system owing to higher employment rates.

Keywords:

• Crisis resolution treatment
• employment
• propensity score matching
• difference-in-difference

Acknowledgements

Danish Special Pool for the Social Area given by the Danish Health Authority is gratefully acknowledged. Moreover, special thanks go to Marianne Simonsen for methodical supervision.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The Danish Health Authority has no financial interest in the subject matter of the paper.

Additional information

Funding

This study was supported by a Danish Special Pool for the Social Area given by the Danish Health Authority.