Abstract
AimsTo critically examine the development of L&D services in England and Wales and critically appraise their evidence base.BackgroundHigh levels of morbidity across the criminal justice pathway are well established. Although the strongest evidence has emerged from prison studies, the court literature also confirms these high levels. In acknowledgment of this, there have been a range of initiatives to improve access to services for mentally ill individuals involved with the criminal justice system. Once such initiative has been the development of court liaison and diversion services (L&D).MethodRelevant literature was identified through a search of the following databases: PubMed, EMBASE, and PsycINFO. Data were appraised and synthesised to provide a comprehensive overview of the development of L&D services and their evidence base.ResultThe provision of L&D services has increased substantially since their first introduction in England and Wales in 1989. Early L&D services were largely small-scale, unfunded local schemes, and were dependent upon the energy and interest of clinicians who chose to lead in this area. This led to geographical variations in provision and variations in L&D model delivery. The Bradley Report (2009) recommended that a national L&D model be created. The roll-out of a national L&D model meant that half the population of England was covered by 2015, with funding assured for a final wave of L&D services to provide for total population coverage.Where implemented, L&D services have been shown to lead to increased numbers of local team referrals. They may reduce court adjournments and the overall amount of time spent attending court. There is also some evidence of an association with improved mental health among both adults and young people, with reductions in re-conviction rates amongst the later. There remain deficiencies in the evidence base with regards to the economic impact of L&D services. The majority of economic assessments of L&D services have been performed in the United States with fewer studies in the UK.ConclusionAlthough there is evidence that liaison and diversion can produce benefits, there is a general recognition that a higher standard of evidence is required, including experimental work and assessment of economic impact. L&D services carry a financial burden, but this may be offset by incorporating the value of the health improvements that may be brought in those who might otherwise not have received treatment.
Highlights
A systematic review to evaluate the effectiveness of mental health literacy interventions implemented in schools and communities in low- and middle- income countries
Despite the wealth of research into the effectiveness of mental health literacy interventions in high-income countries, there is an absence of evaluations of these interventions in low-middle-income countries (LMICs)
This systematic review aims to pool the evidence on effectiveness of these interventions in LMICs
Summary
Josen McGrane1*, Eleanor Carey[2], Emmet Power[1], Niamh Dooley[3], Sean Madden[4], Helen Coughlan[5], Donal Campbell[6], Mary Clarke[5] and Mary Cannon7 1Royal College of Surgeons in Ireland, St Vincent’s University Hospital; 2Royal College of Surgeons in Ireland, St Vincent’s University Hospital, Trinity College Dublin; 3Trinity College Dublin, Royal College of Surgeons in Ireland; 4Independent Scholor; 5Royal College of Surgeons in Ireland; 6Beaumont Hospital and 7Royal College of Surgeons in Ireland, Beaumont Hospital *Corresponding author. In a similar Irish study, 55% of young adults met the criteria for lifetime mental disorder. A systematic review to evaluate the effectiveness of mental health literacy interventions implemented in schools and communities in low- and middle- income countries. Despite the wealth of research into the effectiveness of mental health literacy interventions in high-income countries, there is an absence of evaluations of these interventions in low-middle-income countries (LMICs). This systematic review aims to pool the evidence on effectiveness of these interventions in LMICs. Method. Studies that quantitively measured the effectiveness of mental health literacy interventions amongst schools and communities in LMICs were included, regardless of study design. The review found that mental health literacy interventions may have promising effects, the pooled evidence of the effectiveness in LMICs was inconclusive. The review provides recommendations for policy makers for the development of future interventions
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