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. 2025 Mar 22:30:101785.
doi: 10.1016/j.ssmph.2025.101785. eCollection 2025 Jun.

The impacts of Liverpool Citizen's Advice on Prescription (CAP) on mental health outcomes- an Instrumental Variable (IV) approach

Gebremariam Aregawi  1   2 , Piroddi Roberta  1 , Daras Konstantinos  1 , Anderson De Cuevas Rachel  1 , Abba Katharine  1 , Gabbay Mark  1 , Corcoran Rhiannon  1 , Granger Rachel  3 , Ezeofor Victory  3 , Tudor Edwards Rhiannon  3 , Mahoney Clare  4 , Barr Benjamin  1
Affiliations

The impacts of Liverpool Citizen's Advice on Prescription (CAP) on mental health outcomes- an Instrumental Variable (IV) approach

Gebremariam Aregawi et al. SSM Popul Health. .

Abstract

•Citizens Advice on Prescription provides advice/support via health services to reduce financial insecurity.•The intervention included a quick referral process with proactive follow-up by case workers.•It led to fewer antidepressant prescriptions and mental health emergencies.•It reduces mental health-related GP consultations and A&E attendances.•Citizens advice on prescription likely improves mental health and is cost-saving to the health service.

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Conflict of interest statement

Clare Mahoney is the lead commissioner at NHS Cheshire and Merseyside for the Service. No other authors have any conflicts of interest.

Figures

Fig. 1
Fig. 1
Logic model highlighting pathways through which the CAP programme is expected to impact on health.
Fig. 2
Fig. 2
Direct Acyclic Graph showing potential causal relationships, where Z is an instrument, M are measured mediators between Z and the outcomes Y and C are measured confounders between Z and the outcomes Y and we assume that there are no unmeasured confounders or mediators (U1 and U2).
Fig. 3
Fig. 3
Trend in adjusted outcomes for high and low uptake groups based on the upper and lower quartile of their IV predicted uptake of CAP.
Image 1
Image 2
Image 3
See this image and copyright information in PMC

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