Maximising the health impacts of free advice services in the UK: A mixed methods systematic review

Young, David; Bates, Geoff

doi:10.1111/hsc.13777

Health Social Care Comm

2022

DOI: 10.1111/hsc.13777

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Maximising the health impacts of free advice services in the UK: A mixed methods systematic review

David Young

Geoff Bates

Abstract: After a decade of austerity spending cuts and welfare reform, the COVID-19 pandemic has posed further challenges to the finances, health and wellbeing of workingage, low-income people. While advice services have been widely seen (and funded) as an income maximisation intervention, their health and well-being impact is less clear.

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Cited by 4 publications

References 57 publications

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Money Matters: Time for Prevention and Early Intervention to Address Family Economic Circumstances

Axford

Berry

2023

J of Prevention

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Child poverty is associated with poorer physical and mental health, negative educational outcomes and adverse long-term social and psychological consequences, all of which impact on service demand and expenditure. Until now, however, prevention and early intervention practice has tended to focus on enhancing inter-parental relationships and parenting skills (e.g., via relationship skills education, home visiting, parenting programs, family therapy) or child language, social-emotional and life skills (e.g., early childhood education, school-based programs, youth mentoring). Programs often target low-income neighborhoods or families but rarely address poverty directly. While there is substantial evidence for the effectiveness of such interventions in improving child outcomes, null results are not uncommon and even positive effects are often small, short-term, and difficult to replicate. One avenue to enhance intervention effectiveness is to improve families’ economic circumstances. There are several arguments for this refocusing. It is arguably unethical to focus on individual risk without acknowledging or seeking to address (where relevant) families’ social and economic contexts, while the stigma and material constraints associated with poverty can make it harder for families to engage with psychosocial support. There is also evidence that increasing household income improves child outcomes. Although national policies to alleviate poverty are important, it is increasingly recognized that practice-based initiatives have a role to play (e.g., income maximization, devolved budgets, money management support). However, knowledge about their implementation and effectiveness is relatively thin. For instance, there is some evidence that co-located welfare rights advice in healthcare settings can improve recipients’ financial circumstances and health, but it is mixed and of limited quality. Moreover, there is little rigorous research on whether and how such services affect mediators (parent-child interactions, parenting capacity) and/or child physical and psychosocial outcomes directly. We call for prevention and early intervention programs to attend more to families’ economic circumstances, and for experimental studies to test their implementation, reach and effectiveness.

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Money Matters: Time for Prevention and Early Intervention to Address Family Economic Circumstances

Axford

Berry

2023

J of Prevention

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The positive impact of legal advice and services on the mental wellbeing of UK veterans

Beardmore,

Collier,

Olusanya

et al. 2024

International Journal of the Legal Profession

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Community-based interventions on the social determinants of mental health in the UK: an umbrella review

Williams,

Kirkbride

2024

JPMH

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Purpose There is growing evidence that several social determinants influence mental health outcomes, but whether or not community-based prevention strategies are effective in intervening on these social determinants to improve mental health is unclear. The purpose of this study was to synthesise the state of knowledge on this topic in the UK context, by conducting an umbrella review of the relevant systematic review literature. Design/methodology/approach The authors searched five electronic databases for systematic reviews of community-based interventions that addressed any social determinant of mental health (SDOMH) in the UK, provided that mental health outcomes were measured. They also reported the results according to PRISMA guidelines and synthesised narratively. Findings The search yielded 1,101 citations, of which 10 systematic reviews met inclusion criteria. These reviews included 285 original studies, of which 147 (51.6%) were from the UK. Two reviews focussed on children and young people, with the remainder based on working-age adult populations. The authors identified five categories of SDMOH, where financial insecurity and welfare advice interventions were addressed by the largest number of reviews (n = 4), followed by reviews of interventions around social isolation and support (n = 3) and housing regeneration initiatives (n = 2). Results across all social determinants and mental health outcomes were highly heterogenous, but evidence most consistently supported the effectiveness of interventions addressing financial and welfare support on mental health outcomes. Originality/value This review highlights the paucity of high quality, causal evidence from the UK and beyond on the effectiveness of interventions on the social determinants of mental health; severe methodological heterogeneity hampers progress to identify scalable interventions to improve population mental health.

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Maximising the health impacts of free advice services in the UK: A mixed methods systematic review

Cited by 4 publications

References 57 publications

Money Matters: Time for Prevention and Early Intervention to Address Family Economic Circumstances

Money Matters: Time for Prevention and Early Intervention to Address Family Economic Circumstances

The positive impact of legal advice and services on the mental wellbeing of UK veterans

Community-based interventions on the social determinants of mental health in the UK: an umbrella review

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