Interventions to engage at-risk individuals within health-care system
No.	First author, year/country	N enrolled/analysed	Age	Setting	Targeted population	Target condition	Intervention description	Intervention duration	Assessment time point(s)	Outcomes studied
14	Asarnow, 2005/USA	418/344	13–21	Primary care	Patients with depressive symptoms and their parents (when appropriate)	Depression	6-month health service quality improvement intervention through support and training for clinicians on treatment for people with mental disorders by expert leader teams and care managers	6 months	6 months	–Accessing care –Health outcomes –Satisfaction
15	Asarnow, 2011/USA	181/160	10–18	Emergency department	Suicidal youths and their families	Suicide	Brief family-based therapy session to increase motivation during emergency room visit by reframing the problem, educating families about the importance of treatment, obtaining commitment from youth, identifying triggers and developing and practising a safety plan supplemented by care linkage telephone contacts within the first 48 h after discharge	Single time point with follow-up phone calls after 48 h and additional contacts as needed (usually 1, 2 and 4 weeks post-discharge)	2 months	–Accessing care –Health outcomes
16	Coker, 2019/USA	342/342	5–12	Primary care	Parents of children referred to community mental health clinics	General mental health problems	A 5-min video on community mental health clinic and scheduled visit for a telehealth eligibility screening	Single time point	6 months	–Accessing care –Health outcomes –Satisfaction
17	Donohue, 1998/USA	39/39	Not stated (ca. 12–18)	Outpatient cognitive-behavioural treatment program specialising in adolescent substance dependence and conduct disorder	Adolescents referred as prospective clients and their parents	Conduct disorder and substance abuse	Telephone call by clinical psychology doctoral students to parents about treatment, intake session for parent and youth, motivational reminder calls and incentives to participate in treatment	Single time point	Directly post-intervention	Accessing care
18	Fristad, 2003/USA	52/42	8–11	Clinical research group	Children with mood disorders and their parents	Mood disorders	Didactic and interactive multi-family psycho-education group program; parent sessions focused on providing social support, information and skills, while child sessions focused on feeling less alone, understanding symptoms and effects of treatment and building social skills	6 sessions over 6 weeks	–2 months –6 months	–Attitudes –Accessing care –Health outcomes
19	Gadomski, 2010/USA	397/397	5–16	Primary care	Primary care providers who treat children with possible or probable mental health problems	General mental health problems	Three hour-long communication skills training sessions for primary care clinicians to engage parents and children in diagnosis and treatment and address barriers to treatment with group discussions and 10-min practice visits	Single time point	–2 weeks –3 months –6 months	Accessing care
20	Grupp-Phelan, 2012/USA	24/24	12–17	Emergency department	Patients with suicide-related risk factors	Suicide	Discussion with a study social worker about screening results, patient concerns and available resources; designed to target various barriers and increase motivation for help-seeking behaviour	Single time point	2 months	–Help-seeking –Accessing care –Health outcomes –Satisfaction
21	Gully, 2008/USA	87/51	2–17	Child advocacy centres and outpatient program at hospital	Parents of children who are suspected victims of abuse	General mental health problems	Educational booklet for parents on expectations and perceived value of treatment reviewed together with nurses	Single time point	1 month	–Knowledge –Attitudes –Accessing care –Satisfaction
22	Kourany, 1989/USA	111/111	2–17	Outpatient child psychiatry clinic	Parents of prospective clients	General mental health problems	Reminder telephone call, letter describing what would happen on the first clinic visit, or both the call and the letter	Single time point	Directly post-intervention	Accessing care
23	Lieberman, 2006/USA	71/71	13–22	Primary care	Adolescents with psychosocial issues	General mental health problems	Provision of on-site mental health services (usual care was a referral to an off-site mental health provider)	Single time point	3 months	Accessing care
24	MacLean, 1989/Canada	327/327	<12	Child community mental health centre	Parents of prospective clients	Non-emergency general mental health problems	One of four experimental letters (systematic appointment reminders, change slips requesting if appointment time should be changed, warnings and change slips combined with warnings)	Single time point	Directly post-intervention	Accessing care
25	McKay, 1996a/USA	108/108	Not stated	Child mental health agency	Caretakers requesting mental health services	General mental health problems	Intensive 30-min telephone intervention with a social worker to engage caretaker in help-seeking process by identifying child's problem, framing caretaker actions as having potential to impact the situation, and exploring barriers to help-seeking	Single time point	Directly post-intervention	Accessing care
26	McKay, 1996b/USA	107/107	Not stated	Urban child mental health agency	Parents of prospective clients	Non-emergency general mental health problems	Telephone intake with therapists trained in specific engagement skills, i.e., informing clients about the process of obtaining mental health services, responding to concrete concerns or crisis situations and exploring potential barriers to obtaining services	Single time point	Directly post-intervention	Accessing care
27	McKay, 1998/USA	109/109	1–14	Child mental health agency	Caregivers of urban children who requested services at the mental health agency	General mental health problems	Thirty-minute telephone and in-person engagement intervention by master's level clinicians to clarify the need for mental health care, increase the caretaker's investment in help-seeking, identify attitudes about and previous experiences with mental health care, and over concrete barriers to accessing services	Single time point	18 weeks	Accessing care
28	Parrish, 1986/USA	99/99	2–20	Outpatient behavioural paediatrics clinic	Parents of children referred as prospective clients	Behavioural health problems	Letter informing parents that children would be moved to the bottom of the waiting list if three appointments were missed or letter informing parents that attending appointments would earn a coupon for winning a prize	Single time point	Directly post-intervention	Accessing care
29	Planos, 1986/USA	274/274	<18	Children's mental health centre	Parents of children referred as prospective clients	General mental health problems	Appointment reminder (telephone or letter prompt)	Single time point	1 month	Accessing care
30	Richardson, 2014/USA	101/101	13–17	Primary care	Adolescents who screened positive for depression and their parents	Depression	A 12-month collaborative care intervention delivered by master's-level clinicians involving initial in-person education engagement session, choice of treatment and regular follow-up	12 months	12 months	–Accessing care –Health outcomes –Satisfaction
31	Stern, 2015/Canada	117/99	5–12	Children's mental health centre	Parents of children with mental health problems	General mental health problems	A 10–15 min enhanced engagement phone intake to develop rapport with parents, identify and address likely barriers to treatment, increase parental self-efficacy, hope and treatment motivation	Single time point	Not standardised – several weeks to months	Accessing care
32	Stevens, 2009/USA	179/179	11–20	Primary care	Adolescents who screened positive for at least one of depressive symptoms, suicidal ideation or substance abuse	Depression, suicide and substance abuse	Three phone calls in the first weeks after the first visit to the adolescent management clinic to assess youth's understanding of recommendations, address youth's struggles through case management and use motivational interviewing techniques if youth was ambivalent about treatment	Several weeks to months	6 months	Accessing care
33	Szapocznik, 1988/USA	108/108	12–21	Mental health centre	Adolescent drug abusers and their families	Substance abuse	Engagement intervention during intake interview to overcome family's resistance to treatment by identifying family patterns that interfere with entry into treatment	As many contacts as necessary within 3-week period	3 weeks	–Accessing care –Health outcomes
34	Wiseman, 1998/UK	128/128	Not stated	Child mental health clinic	Parents of prospective clients	Non-emergency general mental health problems	Didactic and interactive multi-family psycho-education group program; parent sessions focused on providing social support, information, skills, while children sessions focused on feeling less alone, understanding symptoms and effects of treatment, and building social skills	Single time point	Directly post-intervention	Accessing care