Mental Health Services for Serious Mental Illness: Scoping Review of Randomised Controlled Trials.
Pablo Roson Rodriguez, Xiao Chen, Marcelo Arancibia and 4 others
PMID 39754413WHAT IT FOUND
Most randomised trials of mental health services for serious mental illness tested outpatient, e-health, ambulatory, residential, case management, discharge, education or assessment care.
This map shows where evidence exists and where gaps remain, not which service works.
Key findings
01The map included 233 randomised trials, and most used a parallel design.
02Most trials were conducted in China, North America or Europe, with only 2.6% from low- and middle-income countries.
03Mobile ambulatory interventions were delivered by nurse staff or community mental health teams in participants' homes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not critically appraise the included trials or combine their results. It cannot show which service works. The DESDE-LTC classification was designed for services, not trials. The authors created extra categories, and those categories could be challenged. The included interventions were heterogeneous and often poorly reported. This made sub-classification difficult. Very few trials came from low- and middle-income countries, and most were from China, North America or Europe. Generalisability is limited. Most trials were outpatient. The review noted the need for further research in different settings. Trials in treatment-resistant schizophrenia, pharmacological treatments, psychotherapies and traditional Chinese medicine were excluded because they had been mapped elsewhere.
Declared interests
The authors declared no conflicts of interest. The Cochrane Schizophrenia Group is described as independent and not-for-profit.
The easy way to misread this
Do not read this map as proof that any mental health service works. The review counted and classified trials, but it did not critically appraise them or combine their outcome results.