Community Rehabilitation Enhanced Support Team (CREST)

The Community Rehabilitation Enhanced Support Team (CREST) is a regional community mental health service to help people live outside of more complex locked rehabilitation.

The goal is to move people using these out of area (OOA) services from inpatient settings and develop new lives nearer to home. Established in 2021, the team aims to empower people to define, build, and live meaningful, independent, and satisfying lives closer to their families and community.

Update for CREST, the Community Rehabilitation Enhanced Support Team

Following four successful years helping people with complex rehabilitation mental health needs to leave hospital, CREST, the West Yorkshire-wide Community Rehabilitation Enhanced Support Team, is being reviewed to meet changing demands for rehabilitation mental health care.

CREST was established in 2020 after extensive consultation with service users, carers and wider stakeholders to help people leave locked rehabilitation inpatient units, and move as quickly and easily as possible into homes in the community with the appropriate support. Many had been living for years in hospitals long distances from their friends and families.

The commissioning of this service is changing in response to the current health system needs in West Yorkshire. Throughout this next year regional community complex rehabilitation provision will move and local community services will be providing care and treatment to people within their own local areas. CREST will continue to work sensitively with people supporting the development of safe transfers of care to their local teams across Bradford, Calderdale, Kirklees, and Wakefield.

Through a local review and development plan, LYPFT will continue to retain and offer the expertise developed from the CREST service, combining this with local expertise within Leeds rehabilitation pathways during 2025/26. A local review will ensure that no service user will be left without treatment or a community placement. Details of the review will be published when formalised. An enhanced community rehabilitation service will continue, hosted by LYPFT and based in Leeds.

Providing consistent patient care

To improve outcomes and facilitate the transition out of locked rehabilitation settings for a defined cohort of OOA service users originating from Leeds, Kirklees and Calderdale, ICS created CREST. In line with this service, the West Yorkshire and Harrogate Health and Care Partnership (WYICS) conducted a comprehensive needs analysis study from service user, carer and staff consultations. They found this group experienced significant disadvantages in multiple forms:

• Exclusion due to geographical placement
• Loss of relationships
• Poor quality of therapeutic environments
• Stressful transitions between hospital and home
• A lack of hope for the future

Understanding complex patient needs and those caring for them

A strong theme from carers was the negative emotional toll experienced in supporting loved ones across the system. The sheer complexities emerging from this unique clinical, geographical and service landscape has meant men and women often spend long periods isolated from the support of their local families and communities. WYICS has launched CREST as the first of three services under its “Complex Rehabilitation Project” to address this disadvantage. It’s aimed at helping those with complex mental health needs move effectively back into the community.

How CREST works for service users and carers

CREST uses a clinical model that is psychologically and trauma-informed to deliver care coordination, specialist direct multi-disciplinary team (MDT) interventions, consultation and peer recovery expertise. This is provided over extended hours (8am to 8pm, seven days a week) to move service users back to their home areas. This includes support provided through the OOA hospital placement, across the transition and into community-based provision for many service users. The CREST team works closely with place-based services, accommodation providers, and family/carers.

CREST also actively contributes to avoiding readmission and preventing OOA placement within the ICS by using the expertise of several perspectives ranging from multiple disciplines to newer family engagement and peer recovery roles.

Our service users have the chance to record their feelings about their journey toward life in the community in this living document.

Introducing CREST CEN

CREST, the West Yorkshire Community Rehabilitation Enhanced Support Team, is celebrating the soft or informal launch of its CEN (Complex Emotional Needs) pathway. It has reached this milestone thanks to the dedication and hard work of its team and collaboration with a wide range of partners since 2021. Read more on our news. 

My Personal Journey: Next Steps

The booklet, which you can download, has been written by the Peer Recovery Workers from CREST, with the help of patients from hospitals across Yorkshire.

Everyone who has played a part in its creation has had their own experience of mental health challenges and getting mental health support. This will make My Personal Journey: Next Steps more relevant to you and your experiences and journey back to the community.

The booklet is a ‘working document,’ meaning it will stay with you while you work with CREST. It can change and develop as you adapt and adjust to community life again.

More information

More information about our work in complex rehabilitation and the needs analysis with service users and carers can be found on the Partnership Website.

For enquiries, please contact CREST administrators at 0113 8556475 or email crest.wyics@nhs.net