Table 2 Meta-analyses effectiveness results: clinical outcomes
Author (year) | Outcome | N of studies (N of participants) | Population | Effect measure | Effect size (95% CI), p-value | Heterogeneity, I2, 95% CI, χ2, df | AMSTAR2 | Summary findings |
|---|---|---|---|---|---|---|---|---|
Depression | ||||||||
 Fang et al. (2022) [47] | Perinatal depression (various end time points) | 16 (3154) | Pregnant women/ women who gave birth within 1 year with diagnosis/ risk of perinatal depression | SMD |  − 0.39 (− 0.54, − 0.24); Z = 9.42, p < 0.00001 (results taken from text) | I2 = 78%; χ2 = 91.38 (df = 20, p < 0.00001) | Critically low | Significant reduction in perinatal depression |
 Huang et al. (2020) [48] | Depression (post-intervention) | 9 (1617) | Pregnant women/ women who gave birth within 1 year with diagnosis /risk of perinatal depression | SMD, Z |  − 0.37 (− 0.66, − 0.08), p = 0.01 Z = 2.47 (p = 0.01) | I2 = 84%, p < 0.00001, Tau2 = 0.14; χ2 = 49.37 (df = 8, p < 0.00001) | Critically low | Significant reduction in perinatal depression scores |
 Huang et al. (2020) [48] | Depression ‘events’ (binary measure—post-intervention) | 7 (1644) | Pregnant women/ women who gave birth within 1 year with diagnosis /risk of perinatal depression | RR, Z | 0.69 (0.49, 0.96), p = 0.03 Z = 2.22 (p = 0.03) | I2 = 70%, p = 0.003 Tau2 = 0.11; χ2 = 20.25 (df = 6; p = 0.003) | Critically low | Significant reduction in risk of perinatal depression |
 Lloyd-Evans et al. (2014) [22] | Depression and anxiety (post-intervention) | 3 (861) | Adults with SMI or those using secondary MH services | SMD |  − 0.10 (− 0.24, 0.03) | I2 = 0%, χ2 = 1.97 (p = 0.37) | Low | No effect |
 Lyons et al. (2021) [35] b | Depression (post-intervention) | 4 (929) | Adults with any mental health condition (including SMI) | SMD |  − 0.09 (− 0.22, 0.04), p = 0.18 | I2 = 0%, χ2 = 1.11 (df = 2) | Critically low | No effect |
 Sun et al. (2022) [43] b | Depression (end of treatment) | 5 (372) | Adults and adolescents with any mental health problem including MH service users without reported diagnoses | SMD |  − 0.05 (− 0.26, 0.15), p = 0.34 | I2 = 0%, χ2 = 1.62 (df = 1, p = 0.76) | Critically low | No effect |
Depression: follow-up | ||||||||
 Lloyd-Evans et al. (2014) [22] | Depression and anxiety (6 months follow-up) | 2 (721) | Adults with SMI or those using secondary MH services | SMD |  − 0.17 (− 0.32, − 0.03) | I2 = 0%, χ2 = 0.15 (p = 0.70) | Low | Significant reduction in depression and anxiety |
 Lyons et al. (2021) [35] b | Depression (3–6 months follow-up) | 3 (674) | Adults with any mental health condition (including SMI) | SMD |  − 0.12 (− 0.27, 0.03), p = 0.11 | I2 = 0%, χ2 = 0.95 (df = 2) | Critically low | No effect |
Clinical recovery | ||||||||
 Smit et al. (2022) [52] | Clinical recovery (post-intervention) | 22 (NR) | Adults with any mental health diagnosis | Hedges’ g | 0.19 (0.11–0.27), p < 0.001 | I2 = 10% (95% CI 0–44) | Low | Significant improvement in clinical recovery |
Clinical recovery: follow-up | ||||||||
 Smit et al. (2022) [52] | Clinical recovery (6–9 months follow-up) | 13 (NR) | Adults with any mental health diagnosis | Hedges’ g | 0.17 (0.08–0.26), p = 0.002 | I2 = 0% (95% CI 0–57) | Low | Significant improvement in clinical recovery |
 Smit et al. (2022) [52] | Clinical recovery (12–18 months follow-up) | 8 (NR) | Adults with any mental health diagnosis | Hedges’ g | 0.10 (− 0.21,0.40), p = 0.48 | I2 = 63% (95% CI 20–83) | Low | No effect |
Mental health symptoms | ||||||||
 Peck et al. (2023) [40] a | Symptom severity (time point not stated) | 5 (1094) | Adults, majority diagnosed with schizophrenia, bipolar disorder or major affective disorders | SMD, Z |  − 0.30 (− 0.55, − 0.04), Z = 2.29 (p = 0.02) | I2 = 75%, Tau2 = 0.06, χ2 = 15.77 (df = 4, p = .003) | Critically low | Significant reduction in symptom severity |
 Wang et al. (2022) [44] | Psychotic symptoms (post-family-led peer support) | 3 (742) | Adult individuals or family members with SMI | SMD, Z |  − 1.45 (− 2.68, − 0.22), Z = 2.32, p = 0.02 | I2 = 98%, Tau2 = 1.92; χ2 = 189.37 (df = 4, p < 0.00001) | Critically low | Significant reduction in psychotic symptoms |
 Lloyd-Evans et al. (2014) [22] | Overall psychiatric symptoms (post-treatment) | 3 (753) | Adults with SMI or those using secondary MH services | SMD |  − 0.07 (− 0.39, 0.24) | I2 = 74%, χ2 = 7.83 (p = 0.02) | Low | No effect |
 Lloyd-Evans et al. (2014) [22] | Symptoms of psychosis (post-treatment) | 2 (696) | Adults with SMI or those using secondary MH services | SMD |  − 0.08 (− 0.27, 0.03) | Not reported | Low | No effect |
 Lyons et al. (2021) [35] b | Global symptoms (post-intervention) | 3 (823) | Adults with any mental health condition (including SMI) | SMD |  − 0.13 (− 0.27, 0.01), p = 0.07 | I2 = 0%, χ2 = 1.11 (df = 2) | Low | No effect |
Mental health symptoms (time point not stated) | 2 (197) | Adults with severe mental health diagnoses | SMD, Z |  − 0.24 (− 0.52, 0.05), Z = 1.65 (p = 0.1) | I2 = 0%, Tau2 = 0; χ2 = 0.52 (df = 2; p = 0.77) | Low | No effect | |
 Sun et al. (2022) [43] b | Anxiety (post-intervention) | 2 (175) | Adults and adolescents with any mental health problem including MH service users without reported diagnoses | SMD | 0.29 (− 0.01, 0.58), p = 0.06 | I2 = 0%, χ2 = 0.09 (df = 1, p = 0.76) | Critically low | No effect |
 Wang et al. (2022) [44] | Psychotic symptoms (post individual-led peer support) | 11 (2651) | Adult individuals or family members with SMI | SMD | –0.30 (–0.73, 0.13), Z = 1.38, p = 0.17 | I2 = 96%; Tau2 = 0.5; χ2 = 270.29 (df = 10, p < .00001) | Critically low | No effect |
Mental health symptoms: follow-up | ||||||||
 White et al. (2020) [45]a | Psychiatric symptoms (6–24 months follow-up) | 6 (857) | Adults using mental health services with any diagnoses | SMD, Z |  − 0.01 (− 0.21, 0.20), Z = 0.0 (p = 0.961) | I2 = 53%, χ2 = 10.7, p = 0.057 | Critically low | No effect |
Service use | ||||||||
 Wang et al. (2022) [44] | Rehospitalisation (last follow-up) | 3 (483) | Adult individuals or family members with SMI | SMD, Z |  − 1.34 (− 1.94, − 0.75), Z = 4.44, p < 0.00001 | I2 = 87%, Tau2 = 0.32; χ2 = 23.15 (df = 3, p < 0.0001) | Critically low | Significant reduction in rehospitalisation |
 Wang et al. (2022) [44] | Duration of hospitalisation (last follow-up) | 3 (483) | Adult individuals or family members with SMI | SMD, Z |  − 1.48 (− 2.56, − 0.41), Z = 2.70, p = 0.007 | I2 = 96%, Tau2 = 1.14; χ2 = 70.97 (df = 3, p < 0.0001) | Critically low | Significant reduction in hospital duration |
 Wang et al. (2022) [44] | Family/carer use of formal community support services (last follow-up) | 4 (483) | Adult individuals or family members with SMI | SMD, Z |  − 1.38 (2.19, − 0.56), Z = 3.32, p = 0.0009 | I2 = 93%, Tau2 = 0.64, χ2 = 42.21 (df = 3, p < 0.00001) | Critically low | Significant reduction in use of community support services |
 Lloyd-Evans et al. (2014) [22] | Duration of admission (post-treatment) | 3 (255) | Adults with SMI or those using secondary MH services | SMD |  − 0.22 (− 0.72, 0.28) p = 0.03 | I2 = 72%, χ2 = 7.16 | Low | No effect |
Length of stay (time point not stated) | 2 (119) | Adults with severe mental health diagnoses | MD, Z |  − 13.41 (− 32.09, 5.27), Z = 1.41 (p = 0.16) | I2 = 28.6%, Tau2 = 89.38; χ2 = 1.4 (df = 1, p = 0.24) | Low | No effect | |
Service use: follow-up | ||||||||
 White et al. (2020) [45]a | Risk of hospitalisation (3–24 months follow-up) | 5 (497) | Adults using mental health services with any diagnoses | RR, Z | 0.86 (0.66, 1.13), Z = 1.1 (p = 0.27) | I2 = 38%, χ2 = 6.5, p = 0.170 | Critically low | Significant reduction in risk of hospitalisation |
 White et al. (2020) [45]a | Days in hospital (9–24 months follow-up) | 5 (453) | Adults using mental health services with any diagnoses | SMD, Z |  − 0.10 (− 0.34, 0.14), Z = 0.8, p = 0.426 | I2 = 39%, χ2 (Q) = 10.7, p = 0.057 | Critically low | No effect |
Other clinical outcomes | ||||||||
 Sun et al. (2022) [43]b | Help-seeking (post-intervention) | 2 (114) | Adults and adolescents with any mental health problem including MH service users without reported diagnoses | SMD | 0.46 (0.10, 0.82), p = 0.01 | I2 = 0%, χ2 = 0.93 (df = 1, p = 0.34) | Critically low | Significant improvement in help-seeking |
 Sun et al. (2022) [43]b | Disclosure-related distress (post-intervention) | 2 (170) | Adults and adolescents with any mental health problem including MH service users without reported diagnoses | SMD |  − 0.53 (− 0.84, − 0.23), p = 0.0006 | I2 = 0%, χ2 = 0.25 (df = 2, p = 0.61) | Critically low | Significant decrease in disclosure-related distress |
 Wang et al. (2022) [44] | Medication adherence (last follow-up) | 5 (371) | Adult individuals or family members with SMI | SMD |  − 0.22 (− 0.43, − 0.01); Z = 2.08, p = 0.04 | I2 = 0%; Tau2 = 0; χ2 = 1.54 (df = 4, p = 0.82) | Critically low | Significant improvement in medical adherence |
 Wang et al. (2022) [44] | Activation (last follow-up) | 3 (375) | Adult individuals or family members with SMI | SMD | 0.43 (0.19, 0.67); Z = 3.46, p = 0.0005 | I2 = 19%; Tau2 = 0.01; χ2 = 2.47 (df = 2, p = 0.29) | Critically low | Significant improvement in activation |
 Sun et al. (2022) [43]b | Disclosure-related withdrawal (post-intervention) | 3 (281) | Adults and adolescents with any mental health problem including MH service users without reported diagnoses | SMD |  − 0.10 (− 0.33, 0.14), p = 0.42 | I2 = 37%, χ2 = 3.20 (df = 2, p = 0.20) | Critically low | No effect |
 Wang et al. (2022) [44] | Alcohol use (last follow-up) | 3 (257) | Adult individuals or family members with SMI | SMD |  − 0.23 (− 0.49, 0.03); Z = 1.73, p = 0.08 | I2 = 0%; Tau2 = 0; χ2 = 1.36 (df = 2, p = 0.51) | Critically low | No effect |
Other clinical outcomes: follow-up | ||||||||
 Chien et al. (2019) [21] | Activation (medium term, 1–6 months follow-up) | 3 (295) | Adults with schizophrenia or similar SMI | MD, Z | 3.68 (− 1.85, 9.22), Z = 1.3 (p = 0.19) | I2 = 80.32, Tau2 = 18.09, χ2 = 10.16 (df = 2, p = 0.01) | High | No effect |