Effects of two forms of crisis cards, i.e. with and without
provided support of the local patients organisation, on the number of crisis contacts with mental health services and the number of (compulsory) admissions

The research is important, firstly since crises and (compulsory) admissions
have a large impact. Secondly since the number of crises has been on the
increase during the past years. Thirdly since there is a lack of effective
crisis intervention to prevent crises and (compulsory) admissions. Finally, the
research is important, because there are doubths about the effectivess of
precent crisis intervention methods.

The effectiveness of crisis intervention methods may be incresed by providing
support by an indepandent consultant during the creation of a so-called crisis
card. The crisis card is the combination of a crisis plan and the abstract of
it on a kind of credit card-sized card. The crisis card is meant to recognize
the signals of the onset of a crisis and to treat it according the agreement
stated in the crisisplan.

Earlier research shows that crises and (compulsory) admissions may be prevented
with a crisis card. The question is in which way a crisis card can be made.

This study examines two two forms of crisis card: (1) crisis card formulated
with an independant consulant, (2) crisis card formulated with a clinician.

The background of the comparison of the two forms of intervention is that the
crisis card formulated with an indepandant consultant is possibly more
effective than the crisis card created with a clinician.
Possibly the patient is more open about his of her preferences during the
crisis situation in the case the card was made with the help of an indepandent
party.

Involvement of a consultant may have disadvantages. It means an additional
link in the treatment proces, because of the duration of making the crisis
card. The threshold may be higher to choose to make a crisis card in the first
place.

This study will investigate if the role of an indepanant consultant has a
positive influence on the patients' needs, the number of crises and
(compulsory) admissions.

Randomised controlled trial with two experimental groups and one control group.

Creation of a crisis card with or without an indepandent consultant. Group 1:
crisis card formulated by the patient with an indepandant consultant; group 2:
crisis card formulated by the patient with a clinician, without a consultant
and group3: control group without a crisis card.

During the contact with the researcher the patients will be interviewed and
asked to answer some self-report questionnaires. The total number of research
contacts is four. The first contact will be before the randomisation,
the next four months afterwards, then again nine months after randomnisation and
finally eighteen month after randomnisation. The duration of every research
contact will be for about an hour.