Authors' objectives:

The first part of this report (the scoping review of effectiveness) provides good information on systematic reviews of effectiveness and insight into which areas have not been covered by recent (since 1994), good quality systematic reviews. It also links evidence from systematic reviews with the recommendations from the NSF.

The second part of this report details the cost-effectiveness evidence from full economic evaluations of different modes of providing mental health services.

Authors' recommendations: Thirty-six good quality systematic reviews have been undertaken and eight are being prepared in the areas of mental health promotion and mental health service delivery. Few of the systematic reviews, however, were able to conclude that an intervention was effective or not. This was due primarily to the poor quality, or limited amount of primary research. The only two interventions, which could be considered to be effective from the included primary research, were assertive outreach and community mental health teams. The care programme approach was not considered to be an effective intervention. For all of the other areas of mental health service delivery evaluated by the systematic reviews, interventions have been evaluated poorly, (or not at all) in the primary research. There are still many areas of mental health service delivery interventions which have not been evaluated by systematic reviews including services targeting more accurate diagnosis and assessment of common mental health problems; interventions within hospital settings, 24-hour staffed accommodation; more accurate assessment of risk of imminent violence (to self or others), and interventions for carers of people with a mental health problem. Only some included outcomes such as user's social networks, user and carer satisfaction, social relationships and quality of life. These outcomes should be incorporated into future systematic reviews and primary research. Undertaking systematic reviews in these areas will not only help to inform about what evidence is available, but can make recommendations for future primary research. It is recommended that Cochrane reviews should be undertaken where possible, but resources need to be available to keep them up-to-date.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport21.pdf

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination