Outreach for clients with complex psychiatric needs

Clients with complex psychiatric needs and associated vulnerabilities like weak social connections, unstable housing or income may struggle to identify support needs and ask for help. In social work, active outreach activities inform and support these clients to minimize negative outcomes like hospitalisation or homelessness.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202404 Registration no: SBU 2023/1123

Question

What systematic reviews have been published regarding outreach in social work for clients with complex psychiatric needs?

Method

A systematic literature search was performed using the following databases: MedLine, Scopus and PsycInfo.

Two authors independently assessed the abstracts of all identified studies.

Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature

1 relevant systematic review with moderate risk of bias was identified [1]. As the review authors did not identify any relevant studies, no results or conclusions are reported. In 1 relevant systematic review, the risk of bias was considered to be high, therefore the results and conclusions are not reported [2].

References

  1. Chilvers R, Macdonald GM, Hayes AA. Supported housing for people with severe mental disorders. Cochrane Database Syst Rev. 2006(4):CD000453. Available from: https://doi.org/10.1002/14651858.CD000453.pub2.
  2. Harrison M, Singh Roy A, Hultqvist J, Pan AW, McCartney D, McGuire N, et al. Quality of life outcomes for people with serious mental illness living in supported accommodation: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2020;55(8):977-88. Available from: https://doi.org/10.1007/s00127-020-01885-x.

Search strategies

Medline via OvidSP 12 Jan 2024
/ = Term from the MeSH controlled vocabulary; exp= Term from MeSH including terms found below this term in the MeSH hierarchy;.ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords;.kw = Keywords, exact;.bt = Book title. NLM Bookshelf.; .pt = Publication type; .ja = Journal abbreviation; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other.; * or $ = Truncation
Search terms Items found
Population:
1.& “Diagnosis, Dual (Psychiatry)”/ 3739
2. Mental Disorders/ 179 383
3. “Bipolar and related disorders”/ or Depressive Disorder, Major/ or Depressive Disorder, Trestment-Resistant/ or Borderline Personality Disorder/ 48 773
4. exp Substance-Related Disorders/ 314 219
5. Vulnerable Populations/ 12 927
6. Financial Stress/ 1165
7. Housing Instability/ or Ill-Housed Persons/ 10 086
8. or / 1-7 542 459
9. (((complex or severe) adj4 (psychiatric or mental)) or dual diagnosis).ab,bt,kf,ti. 22 108
10. (psychosis or psychotic or schizophreni* or schizoaffective or paraphreni* or bipolar or (manic adj2 depress*) or ((major or severe) adj2 depressi*) or borderline).ab,bt,kf,ti. 358 359
11. (homeless* or ((unstable or insecur* or instability) adj2 (housing or financial)) or vulnerab* or poverty).ab,bt,kf,ti. 241 946
12. or / 9-11 593 264
13. 8 or 12 1 039 666
Intervention:
14. Community mental health services/ 19 076
15. Social work, Psychiatric/ 2699
16. House Calls/ 4209
17. (outreach or visiting or "home visit*" or contact* or "door to door" or (assertive adj3 (community or treatment or care))).ab,bt,kf,ti. 540 353
18. or / 14-17 561 550
Study types: systematic reviews and meta-analysis
19. ((Systematic Review/ or Meta-Analysis/ or Cochrane Database Syst Rev.ja. or ((systematic adj4 review) or "meta analys*" or metaanalys*).ti,bt,ab.) not (editorial/ or letter/ or case reports/))  
Combined sets:
20. 13 and 18 and 19 1334
Final result
21.   1334

 

Scopus via scopus.com 12 Jan 2024
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields W/n = Within. Proximity operator retrieving terms within n words from each other. PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words. LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range. DOCTYPE = Publication type “re” = review “le” = letter “ed” = editorial “ch” = book chapter “cp” = conference proceedings * = Truncation “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. TITLE-ABS-KEY(((complex OR severe) W/3 (psychiatric OR mental)) OR "dual diagnosis") 31 233
2. TITLE-ABS-KEY ( psychosis OR psychotic OR schizophreni* OR schizoaffective OR paraphreni* OR bipolar OR ( manic W/1 depress* ) OR ( ( major OR severe ) W/1 depressi* ) OR borderline ) 663 749
3. TITLE-ABS-KEY(homeless* OR ((unstable OR insecur* OR instability) W/1 (housing OR financial)) OR vulnerab* OR poverty) 725 227
4. 1 OR 2 OR 3 1 392 197
Intervention:
5. TITLE-ABS-KEY ( outreach OR visiting OR "home visit*" OR contact* OR "door to door" OR “risk management” OR ( assertive W/2 ( community OR treatment OR care)) OR (check* W/1 (welfare OR wellness OR in))) 1 789 580
Study types: systematic reviews and meta-analysis
6. TITLE-ABS-KEY ( ( systematic  W/2 review ) OR "meta analy*" OR metaanaly* ) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “ch”) OR EXCLUDE (DOCTYPE, “cp”))  
Combined sets:
7. 4 AND 5 AND 6 1279
Final result
8.   1279

 

PSYCINFO via EBSCO 12 Jan 2024
TI = Title: AB = Abstract; SU = Keyword, exact or part (including all other fields for indexed and author keywords); DE = Exact keyword; TX = All text; MR = Methodology; Nn = Near. Proximity operator retrieving terms within n words from each other.; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. TI ( (((complex OR severe) N3 (psychiatric OR mental)) OR "dual diagnosis" OR psychosis OR psychotic OR schizophreni* OR schizoaffective OR paraphreni* OR bipolar OR ( manic N1 depress* ) OR ( ( major OR severe ) N1 depressi* ) OR borderline OR homeless* OR ((unstable OR insecur* OR instability) N1 (housing OR financial)) OR vulnerab* OR poverty ) OR AB ( (((complex OR severe) N3 (psychiatric OR mental)) OR "dual diagnosis" OR psychosis OR psychotic OR schizophreni* OR schizoaffective OR paraphreni* OR bipolar OR ( manic N1 depress* ) OR ( ( major OR severe ) N1 depressi* ) OR borderline OR homeless* OR ((unstable OR insecur* OR instability) N1 (housing OR financial)) OR vulnerab* OR poverty ) OR SU ( (((complex OR severe) N3 (psychiatric OR mental)) OR "dual diagnosis" OR psychosis OR psychotic OR schizophreni* OR schizoaffective OR paraphreni* OR bipolar OR ( manic N1 depress* ) OR ( ( major OR severe ) N1 depressi* ) OR borderline OR homeless* OR ((unstable OR insecur* OR instability) N1 (housing OR financial)) OR vulnerab* OR poverty ) 537 855
Intervention:
2. TI ( outreach OR visit* OR contact* OR ”door to door” OR “risk management” OR (check* N1 (welfare OR wellness OR in)) OR ( assertive N2 ( community OR treatment ) ) ) OR SU ( outreach OR visit* OR contact* OR ”door to door” OR “risk management” OR (check* N1 (welfare OR wellness OR in)) OR ( assertive N2 ( community OR treatment ) ) ) OR AB ( outreach OR visit* OR contact* OR ”door to door” OR “risk management” OR (check* N1 (welfare OR wellness OR in)) OR ( assertive N2 ( community OR treatment ) ) ) 158 281
Study types: systematic reviews and meta-analysis
3.; TI((systematic n3 review) OR "meta analys*" OR metaanalys*) OR AB((systematic n3 review) OR "meta analys*" OR metaanalys*) OR SU((systematic n3 review) OR "meta analys*" OR metaanalys*) OR (MR "Systematic Review" OR MR "meta analysis")  
Combined sets:
4.; 1 AND 2 AND 3 480
Final result
5.   480
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