Older adults living with mental health issues often experience crises and require urgent intervention. It has been shown that assessing and treating older people who are experiencing a crisis in their own home can enhance outcomes compared with hospital admission. The author describes the implementation of a pilot intensive support team, which was designed to provide care in a patient’s home when they or their carer experienced a crisis that may otherwise have required hospital admission. This article details the implementation and outcomes of the intensive support team, and explains some of the challenges experienced by the team, in particular during the COVID-19 pandemic.