精神卫生服务中的早期干预：系统综述的快速综述。
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摘要 背景：精神健康障碍构成了巨大的全球疾病负担，许多人因未能及时获得适当护理而经历显著延误。早期干预已成为改善精神健康连续谱中临床、功能和经济结局的关键策略。尽管关于早期干预的证据已较为充分，但跨诊断、年龄组和服务场所对早期干预模式进行更广泛的综合梳理仍有所欠缺。 目的：本快速审查旨在梳理并综合关于早期干预精神健康服务的系统评价证据，为政策制定、规划及实施策略提供参考。 方法：本快速审查基于系统评价和荟萃分析，旨在及时综合早期干预精神健康服务的高级别证据。检索了七个电子数据库（MEDLINE、PubMed、Embase、PsycINFO、CINAHL、Cochrane Library 和 Scopus），纳入2015年1月至2025年6月期间发表的英文系统评价和荟萃分析。符合条件的评价研究了针对患有或有罹患精神健康障碍风险个体的早期干预模式，并报告了与有效性、可及性、成本效益、患者满意度或系统层面绩效相关的结局。数据采用叙述性综合方法进行分析。 结果：共11篇系统综述和荟萃分析符合纳入标准。精神病早期干预服务持续降低住院率、治疗中断率和症状严重程度，同时改善社会和职业功能。以家庭为中心的干预措施增强了照护者的知识水平和幸福感。针对儿童和青少年的简短危机干预模式减少了急诊重复就诊和住院入院。数字和智能手机支持的干预措施显示出可行性和用户参与度，但持续临床获益的证据仍然有限。经济学评价显示，与常规照护相比，早期精神病干预具有成本效益，但来自低收入和中等收入国家的数据较为稀少。有效实施的主要障碍包括病耻感、照护路径碎片化以及心理健康素养不足；促进因素包括家庭参与、照护连续性和灵活的服务提供方式。 结论：早期干预模式改善结局，且通常具有成本效益。为最大化影响力，卫生系统应优先考虑可及性、连续性、家庭参与和文化适应性，同时在不同环境中扩大对数字化和社区为基础的方法的评价。 引言 精神健康障碍是全球疾病负担的最主要单一因素，其总体影响超过了所有其他健康状况：它们约占全球疾病负担的13%，凸显了其对个人、家庭和社会的重大影响（）。从具体健康指标来看，精神疾病占全部残疾所致生命损失年（YLDs）的32.4%，反映了这些疾病长期且往往呈慢性化的特点，可能在一生中损害日常功能（）。此外，它们占伤残调整生命年（DALYs）的13%，这一综合指标结合了因过早死亡所致的生命损失年和残疾状态下的生命年（）。这一不断增加的负担不仅凸显了全球精神健康挑战的规模，也凸显了通过全面且可持续的战略来满足精神健康需求的紧迫性。尽管人们对精神健康重要性的认识不断提高，但许多地区的相关服务仍存在资金不足、污名化和碎片化的问题，需要创新和多层面的方法以克服这些障碍（–）。这凸显了预防、早期干预和可及的治疗以减轻其影响的迫切需求。 解决对高质量精神卫生服务未满足的需求，使其响应患者需求并维护公民的精神健康权利，可以通过战略规划、定期年度评估以及有针对性地提升服务质量来逐步实现（）。此外，使用明确界定的质量指标进行定性和定量评估，对于识别社会弱势群体的需求至关重要。此类评估使国家能够采取知情的政治行动，以保障全民普遍且公平地获得精神卫生服务（）。 精神卫生服务的质量在各国内部及国与国之间差异很大，这通常反映在每个卫生系统内部国际科学机构制定的临床指南与日常实践现实之间的差距上（）。由于各国精神病学体系不同，针对相同症状或病症所做的临床决策可能各异，这受到资源可及性和提供优质护理机会的影响。评估干预质量的研究一致表明，日常临床实践通常未达到国家和国际指南所规定的标准（）。 精神卫生服务中的早期干预 预防性心理健康策略通常分为三个层级：普遍预防，针对一般人群；选择性预防，侧重于高风险个体；以及指向性预防，针对已表现出心理健康问题早期迹象的人群（）。指向性预防通常涉及在初级和社区心理健康机构中对表现出早期症状的个体进行及时干预（）。 早期干预是医疗服务中一个成熟的概念，强调及时识别并实施针对疾病分期的治疗（）。当治疗被主动提供并根据疾病阶段进行定制时，可以预防或减轻不良后果，从而减少未来对昂贵或有创性护理的需求（）。然而，尽管其益处已得到证实，心理健康领域中早期干预策略的采纳速度相对较慢（）。大多数精神疾病在青春期和成年早期（约12-30岁）出现，这是一个社会、心理和生物发展的关键时期（，）。在这一阶段延迟接受有效护理可能扰乱重要的发育里程碑，并对个体的健康、社会关系和职业结局产生持久影响（）。 精神卫生保健的服务提供往往无法与精神障碍的发病模式和疾病负担相一致，即使在先进的卫生系统中也是如此（）。在全球范围内，获得循证精神卫生服务的机会仍然不足，而那些最终获得治疗的人，通常也是在显著延迟之后才得到治疗（，，）。未治疗期持续时间，即从精神障碍发病到开始适当治疗之间的时间，在精神病性障碍中可为1-2年，而在强迫症（OCD）中可长达10年（–）。随着时间推移，未经治疗的精神疾病可能因功能衰退、神经生物学改变和根深蒂固的行为模式等因素而变得更加顽固（，）。较长的未治疗期持续时间 consistently 与较差的症状改善、功能下降以及各诊断类别中治疗反应性降低相关（，）。 精神卫生领域在制定早期干预框架、扩展精神病早期服务以及创建面向青年的项目方面取得了显著进展。证据表明，早期干预能有效预防或延迟精神障碍的发生，并且当系统化实施时，既具有可及性又具有成本效益（，）。 虽然早期精神病项目现已成熟确立（, ），但未来的工作还需进一步聚焦于维持忠实度、确保连续性，并将早期干预扩展到更广泛的重性和非精神病性障碍。需要更多高质量研究来确定最有效的干预强度、持续时间以及改善功能结局的策略。维持治疗获益至关重要，过早脱离治疗存在复发和不一致照护的风险。针对不同阶段、按比例配置资源的干预措施，类似于肿瘤照护中的模式，是维持康复和长期稳定的最佳途径（）。 推进早期干预的努力，尤其是针对阈下精神病和改革青年心理健康服务，引发了争论。批评者担心，扩大心理保健可能导致过度诊断和过度治疗，或者有限的资源应集中于严重的晚期疾病（）。然而，投资于早期发现最终可以减轻后期服务的压力，这与其它慢性病的情况非常相似（）。 关于过度治疗的担忧可能依然存在；然而，在获得适当心理健康护理方面，仍然普遍存在实质性治疗缺口和延迟 (, )。虽然过早用药的情况偶有发生，但这通常反映的是心理社会支持不足，而非早期干预本身的缺陷 (, )。在识别高危个体方面，关于假阳性的问题仍然存在，约36%的高危个体在3年内发展为精神病 ()。尽管如此，在针对性的高危人群中，预测准确性有所提高 ()。阶梯式护理模式通过最初提供强度最低的循证干预措施（包括心理教育、认知行为疗法、家庭支持和密切临床监测），同时将药物治疗保留给症状持续、加重或进展至后期临床阶段的个体，从而有助于最大限度地减少过度治疗 (, )。心理社会服务获取受限可能导致过早依赖药物。同样，跨诊断临床分期模式将精神障碍概念化为通过连续阶段进展，从而使干预措施能够与疾病严重程度相匹配，而非与诊断类别相匹配 (, )。这种方法减少了不必要的治疗暴露，最大限度地减少了病耻感，并促进了更安全、更有效的早期干预。 证据强烈支持广泛采用早期干预，尤其针对精神病性障碍（）。进一步进展取决于处理阈下病例、缩短未治疗时间、保持模型保真度以及确保照护的连续性。尽管精神病学在这一领域处于领先地位，但针对非精神病性障碍（包括重性抑郁障碍、双相障碍、焦虑障碍和进食障碍）的证据也在不断增加（, ）。双相障碍的早期干预显示出巨大潜力，因为治疗在疾病早期最为有效，而复发可能导致脑部改变（）。同样，对于抑郁障碍，早期干预仍然是最佳方法，甚至可能预防完整疾病发作（）。 预防性医疗保健策略，尤其是早期干预，可增强治疗有效性，减少疾病带来的痛苦和损害，并改善家庭整体生活质量。其重点在于健康促进、早期筛查和康复，最终恢复最大功能并将残疾降至最低（）。 尽管早期干预的证据基础正在增长，现有系统评价往往侧重于特定诊断（如精神病、抑郁症）、亚人群（如青年）或单一结局指标(, , )。目前缺乏一项针对总体人群（即所有年龄组）中多个关注结局的综合综述。此外，近年来，受技术进步、服务改革及疫情相关干扰的驱动，早期干预服务的格局发生了显著演变 (, )。 本快速综述旨在通过综合关于所有年龄组早期干预精神卫生服务的系统评价证据来填补这一空白，重点关注五个关键结局领域：服务有效性、可及性、成本效益、患者满意度和系统层面结局。在本综述中，服务有效性指临床和功能结局；可及性反映服务可用性、及时获取、接受度和参与度；成本效益考虑的是成本与结局及资源使用之间的关系；患者满意度涵盖照护体验和可接受性；系统层面结局包括医疗保健利用、服务协调和整体服务绩效。研究结果将为在不同环境中寻求改善精神卫生服务提供的政策制定者、服务规划者和临床医生提供参考。 研究问题 关于精神障碍早期干预服务的文献范围如何？ 文献中报告的早期干预服务的类型和特点以及护理路径有哪些？ 关于早期干预服务的服务有效性、可及性、成本效益、患者满意度和系统层面结局，存在哪些证据？ 哪些因素影响早期干预服务的实施（即实施的障碍和促进因素）？ 方法 本快速综述（针对系统评价和荟萃分析）旨在对早期干预心理健康服务的高级别证据进行及时综合。综述采用了简化的证据综合方法，该方法基于既定的快速综述方法论和系统评价实施原则。综述问题和纳入标准采用人群、干预、对照和结局（PICO）框架制定（）。综述过程的报告遵循系统评价和荟萃分析首选报告条目（PRISMA 2020）声明（）。选择快速综述框架是为了能够对与心理健康政策、服务规划和实施相关的高级别证据进行务实且及时的综合。该方法在保持系统化和透明的综述程序的同时，实现了简化的证据综合。 数据检索 本研究对七个电子数据库实施了全面的检索策略：MEDLINE、PubMed、Embase、PsycINFO、CINAHL、Cochrane Library 和 Scopus。检索采用了受控词汇表术语（如 MeSH）与涉及早期干预和心理健康服务的自由文本关键词的组合，并酌情应用了布尔运算符和截词符。所纳入综述及相关出版物的参考文献列表亦被筛查，以识别其他符合条件的研究。为获取当代证据，检索限定于2015年1月至2025年6月期间的英文出版物。检索于2025年6月进行。为保持一致性，文献检索由一名研究团队成员（R. A.）执行，而所有检索结果均由研究团队独立审查，以确保检索结果的准确性和完整性。用于实现早期干预、心理健康服务及综述级证据合成概念的数据库特定检索策略见附录。 纳入标准 纳入的研究为荟萃分析或系统评价（无论是否包含荟萃分析），其关注对象为在整个生命周期中经历或存在精神健康障碍风险的个体的早期干预策略或护理模式。所纳入的评价必须至少评估以下结局之一：有效性、可及性、成本效益、患者满意度或系统层面结局。仅考虑以英文发表的同行评审文章。同行评审状态在全文筛检期间通过数据库索引信息和期刊出版商记录（必要时）进行核实。符合条件的研究仅限于在所选定电子数据库中索引的同行评审学术期刊上发表的文章。若评价为原始研究、叙述性综述、范围综述、快速综述、伞状综述、方案、学位论文、会议摘要或其他形式的非同行评审文献，则予以排除。 研究筛选 所有检索到的记录均导入Covidence（一种系统评价软件管理工具）。重复记录由Covidence自动识别并删除。随后由两名评审员（RAA和MKA）依据纳入标准独立筛选标题和摘要。对可能相关研究的全文进行检索，并由两名评审员（RAA和MKA）详细评估。任何阶段出现分歧均通过讨论解决，或由第三名评审员（BA）裁决。 数据提取 数据提取使用Microsoft Excel中的标准化数据提取表进行。该表记录了文献信息，如作者、年份，以及综述特征，包括综述类型、纳入研究数量和检索的数据库；人群特征，如年龄组和诊断或风险特征；干预详情，包括类型、实施方式、环境和持续时间；以及与有效性、可及性、成本效益、患者满意度和系统层面结果相关的报告结局。主要发现、结论和已识别的研究空白也被记录。数据提取由一名评价员进行，并由第二名评价员独立核实其准确性和完整性。纳入研究的特征总结于。 纳入的系统综述的特征和主要发现。 ARMS，精神病风险状态；CHEC，卫生经济标准共识；CI，置信区间；cNMA，成分网络荟萃分析；EIP，精神病早期干预；EIS，早期干预服务；FEP，首发精神病；HTA，卫生技术评估；iSMD，间接标准化均数差；PIN，个人识别号；QALY，质量调整生命年；RCT，随机对照试验；RoB 2，偏倚风险2；RR，风险比；SD，标准差；SMD，标准化均数差；TAU，常规治疗；UHR-T，后续转变为精神病的超高风险个体。 数据综合 研究结果采用描述性方法进行综合，并以叙述和表格两种形式呈现。综合分析的侧重点在于对纳入的系统评价和荟萃分析中的研究结果进行总结和比较，识别与早期干预心理健康服务相关的共同主题、干预特征、实施因素及证据空白。研究结果按照预定关注的五个结局领域进行组织：有效性、可及性、成本效益、患者满意度和系统层面结局。 在可获得的情况下，提取并总结了纳入的荟萃分析中报告的与结局指标、综合方法、异质性和敏感性分析相关的信息。鉴于快速综述框架以及及时综合高质量证据的目标，本研究未使用如“系统评价评估工具2（AMSTAR 2）”或“系统评价偏倚风险评估工具（ROBIS）”等工具对纳入的综述进行独立的正式方法学质量评价。然而，在可获得的情况下，提取了纳入综述中报告的有关偏倚风险或评价的信息，因此，总体研究结果应谨慎解读。 该研究从所检索的数据库中识别出337项研究。Covidence软件自动筛选并排除了87项重复研究。剩余250项研究根据作者的纳入标准，仅基于标题和摘要进行筛选，得到42篇文献进入全文筛选。剩余文献由两位评审者进行全文筛选，其中31项研究被排除。共有11项研究符合纳入标准，纳入本综述。研究筛选过程见附图。 PRISMA流程图，显示筛选结果。 研究特征 共有11项系统评价和荟萃分析符合纳入标准。其中大多数在高收入国家开展，5项来自英国，3项来自美国，2项来自澳大利亚，1项由英国和荷兰联合开展。尽管。
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【Abstract】 BACKGROUND: Mental health disorders account for a substantial global burden of disease, with many individuals experiencing significant delays in receiving appropriate care. Early intervention has emerged as a key strategy to improve clinical, functional, and economic outcomes across the mental health continuum. Although evidence surrounding early intervention is well established, a broader synthesis of early intervention models across diagnoses, age groups, and service settings has been lacking. OBJECTIVES: This Rapid Review sought to map and synthesize systematic review evidence on early intervention mental health services to inform policy, planning, and implementation strategies. METHODS: This rapid review of systematic reviews and meta-analyses was conducted to provide a timely synthesis of high-level evidence on early intervention mental health services. Seven electronic databases (MEDLINE, PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, and Scopus) were searched for English-language systematic reviews and meta-analyses published between January 2015 and June 2025. Eligible reviews examined early intervention models for individuals with or at risk of mental health disorders and reported outcomes related to effectiveness, accessibility, cost-effectiveness, patient satisfaction, or system-level performance. Data were synthesized narratively. RESULTS: Eleven systematic reviews and meta-analyses met the inclusion criteria. Early Intervention in Psychosis services consistently reduced hospitalization, treatment discontinuation, and symptom severity while improving social and vocational functioning. Family-focused interventions enhanced caregiver knowledge and wellbeing. Brief crisis intervention models for children and youth reduced emergency department revisits and inpatient admissions. Digital and smartphone-enabled interventions demonstrated feasibility and user engagement, though evidence for sustained clinical benefit remains limited. Economic evaluations showed early psychosis intervention to be cost-effective relative to standard care, but data from low- and middle-income countries were sparse. Key barriers to effective implementation included stigma, fragmented care pathways, and insufficient mental health literacy; facilitators included family involvement, continuity of care, and flexible service delivery. CONCLUSIONS: Early intervention models improve outcomes and are often cost-efficient. To maximize impact, health systems should prioritize accessibility, continuity, family engagement, and cultural responsiveness, while expanding evaluation of digital and community-based approaches across diverse settings. 【Introduction】 Mental health disorders represent the single most significant contributor to the global burden of disease, surpassing all other health conditions in their overall impact: they account for approximately 13% of the global burden of disease, underscoring their significant impact on individuals, families, and societies (). When examined in terms of specific health metrics, mental illnesses are responsible for 32.4% of all years lived with disability (YLDs), reflecting the prolonged and often chronic nature of these conditions that can impair daily functioning over a lifetime (). In addition, they make up 13% of disability-adjusted life years (DALYs), a comprehensive measure that combines years lost due to premature death and years lived with disability (). This growing burden underscores not only the scale of mental health challenges globally but also the urgency of addressing mental health needs through comprehensive and sustainable strategies. Despite the increasing recognition of the importance of mental health, services in many regions remain underfunded, stigmatized, and fragmented, requiring innovative and multifaceted approaches to overcome these barriers (–). This highlights the urgent need for prevention, early intervention, and accessible treatment to reduce their impact. Addressing the unmet need for high-quality mental health services that are responsive to patients' needs and uphold citizens' right to mental health can be achieved gradually through strategic planning, regular annual evaluations, and targeted improvements in service quality (). Furthermore, both qualitative and quantitative assessments using well-defined quality indicators are essential for identifying the needs of disadvantaged social groups. Such evaluations enable the state to take informed political action to guarantee universal and equitable access to mental health services for all (). The quality of mental health services varies greatly both across and within countries, often reflected in the gap within each health system between the clinical guidelines established by international scientific bodies and the realities of daily practice (). Since psychiatric systems differ from one country to another, the clinical decisions made for the same symptoms or conditions can vary, influenced by resource availability and opportunities to deliver quality care. Research assessing intervention quality consistently shows that everyday clinical practice generally falls short of the standards outlined in national and international guidelines (). 【Early interventions in mental health services】 Preventive mental health strategies are typically categorized into three levels: universal prevention, which targets the general population; selective prevention, which focuses on individuals at higher risk; and indicated prevention, which is aimed at those already showing early signs of a mental health issue (). Indicated prevention often involves timely interventions in primary and community mental health settings, directed at individuals exhibiting early symptoms (). Early intervention, a well-established concept in healthcare services, emphasizes the timely identification and implementation of stage-specific treatments (). When treatment is provided proactively and tailored to the stage of illness, it can prevent or mitigate adverse outcomes, thereby reducing the future need for expensive or invasive care (). However, despite its proven benefits, the adoption of early intervention strategies within mental health has been relatively slow (). Most mental illnesses emerge during adolescence and early adulthood (approximately ages 12–30), a critical period of social, psychological, and biological development (, ). Delays in receiving effective care during this phase can disrupt essential developmental milestones and have enduring impacts on individuals' health, social relationships, and occupational outcomes (). Service delivery for mental health care often fails to align with the patterns of onset and disease burden associated with mental disorders, even within advanced health systems (). Globally, access to evidence-based mental health services remains inadequate, and for those who do eventually receive care, it typically occurs only after significant delays (, , ). The duration of untreated illness, thus the time between the onset of a psychiatric disorder and the start of appropriate treatment, can span from 1–2 years in cases of psychosis to as long as 10 years for obsessive compulsive disorder (OCD) (–). Over time, untreated mental illnesses may become more deeply rooted due to factors such as functional decline, neurobiological changes, and entrenched behavioral patterns (, ). A prolonged duration of untreated illness has been consistently linked with poorer symptom improvement, diminished functioning, and reduced treatment responsiveness across diagnostic categories (, ). The mental health field has made notable progress in developing early intervention frameworks, expanding early psychosis services and creating youth-focused programs. Evidence shows that early intervention effectively prevents or delays mental disorders and, when systematically implemented, is both accessible and cost-effective (, ). While early psychosis programs are now well established (, ), there is a further need for future efforts to focus on maintaining fidelity, ensuring continuity, and extending early intervention to a broader range of severe and non-psychotic disorders. More high-quality studies are needed to determine the most effective intervention intensity, duration, and strategies for improving functional outcomes. Sustaining treatment gains is essential, premature disengagement risks relapse and inconsistent care. Stage-specific, proportionately resourced interventions, similar to models in cancer care, offer the best means to preserve recovery and long-term stability (). Efforts to advance early intervention, especially for subthreshold psychosis and reform youth mental health services, have sparked debate. Critics worry that expanding mental healthcare may lead to overdiagnosis and overtreatment, or that limited resources should focus on severe, late-stage illnesses (). However, investing in early detection can ultimately reduce strain on later-stage services, much like in other chronic diseases (). Concerns about overtreatment may persist; however, substantial treatment gaps and delays in accessing appropriate mental health care remain widespread (, ). While premature medication use occasionally occurs, this usually reflects insufficient psychosocial support rather than flaws in early intervention (, ). Questions about false positives in identifying at-risk individuals remain, with roughly 36% developing psychosis within 3 years (). Nevertheless, prediction accuracy improves in targeted high-risk populations (). Stepped-care models help minimize overtreatment by initially providing the least intensive evidence-based interventions, including psychoeducation, cognitive behavioral therapy, family support, and close clinical monitoring, while reserving pharmacological treatment for individuals whose symptoms persist, worsen, or progress to later clinical stages (). Limited access to psychosocial services may otherwise result in premature reliance on medication. Similarly, the transdiagnostic clinical staging model conceptualizes mental disorders as progressing through successive stages, allowing interventions to be matched to illness severity rather than diagnostic category (, ). This approach reduces unnecessary treatment exposure, minimizes stigma, and promotes safer, more effective early intervention. The evidence strongly supports widespread adoption of early intervention, especially for psychosis (). Further progress depends on addressing subthreshold cases, reducing untreated durations, maintaining model fidelity, and ensuring continuity of care. While psychosis research leads the field, evidence for non-psychotic disorders including major depressive disorder, bipolar disorder, anxiety disorders, and eating disorders is growing (, ). Early intervention for bipolar disorder shows strong potential, as treatment is most effective early and relapse can cause brain changes (). Similarly, for depression, early intervention remains the optimal approach and may even prevent full disorder onset (). Preventive healthcare strategies, particularly early intervention, enhance treatment effectiveness, reduce the pain and damage caused by diseases, and improve overall quality of life for families. They focus on health promotion, early screening, and rehabilitation, ultimately restoring maximum function and minimizing disability (). While the evidence base for early intervention is growing, existing systematic reviews tend to focus on specific diagnoses (e.g., psychosis, depression), subpopulations (e.g., youth), or single outcome measures (, , ). There is a lack of a comprehensive synthesis that addresses multiple outcomes of interest across the overall population, broadly defined (i.e., all age groups). Furthermore, the landscape of early intervention services has undergone significant evolution in recent years, driven by technological advancements, service reforms, and pandemic-related disruptions (, ). This rapid review aims to address this gap by synthesizing evidence from systematic reviews on early intervention mental health services across all age groups, with a focus on five key outcome domains: service effectiveness, accessibility, cost-effectiveness, patient satisfaction, and system-level outcomes. In this review, service effectiveness refers to clinical and functional outcomes; accessibility reflected service availability, timely access, uptake, and engagement; cost-effectiveness considered costs in relation to outcomes and resource use; patient satisfaction captured experiences and acceptability of care; and system-level outcomes included healthcare utilization, service coordination, and overall service performance. The findings will inform policymakers, service planners, and clinicians seeking to improve mental health service delivery across diverse settings. 【Research questions】 What is the extent of the literature on early intervention services for mental health disorders? What are the types and characteristics of early intervention services and care pathways reported in the literature? What evidence exists regarding the service effectiveness, accessibility, cost-effectiveness, patient satisfaction, and system-level outcomes of early intervention services? What factors influence the implementation of early intervention services (i.e., barriers and facilitators to implementation)? 【Methods】 This rapid review of systematic reviews and meta-analyses was conducted to provide a timely synthesis of high-level evidence on early intervention mental health services. The review adopted a streamlined evidence synthesis approach informed by established rapid review methodologies and principles of systematic review conduct. The review question and eligibility criteria were developed using the Population, Intervention, Comparator, and Outcome (PICO) framework (). Reporting of the review process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) Statement (). A rapid review framework was selected to enable a pragmatic and timely synthesis of higher-level evidence relevant to mental health policy, service planning, and implementation. This approach allowed for streamlined evidence synthesis while maintaining systematic and transparent review procedures. 【Data search】 A comprehensive search strategy was applied to seven electronic databases: MEDLINE, PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, and Scopus. The search used a combination of controlled vocabulary terms (e.g., MeSH) and free-text keywords relating to early intervention and mental health services, with Boolean operators and truncation applied as appropriate. Reference lists of included reviews and related publications were also screened to identify additional eligible studies. To capture contemporary evidence, the search was restricted to English-language publications from January 2015 to June 2025. The search were conducted in June 2025. For consistency, the literature search was conducted by one study team member (R. A.), while all retrieved results were independently reviewed by the study team to ensure the accuracy and completeness of the search findings. Database-specific search strategies used to operationalize the concepts of early intervention, mental health services, and review-level evidence synthesis are provided in . 【Inclusion criteria】 Studies were included if they were meta-analysis, or systematic reviews, with or without meta-analyses, that focused on early intervention strategies or models of care for individuals across the lifespan experiencing or at risk of mental health disorders. Reviews were required to assess at least one of the following outcomes: effectiveness, accessibility, cost-effectiveness, patient satisfaction, or system-level outcomes. Only peer-reviewed articles published in English were considered. Peer-reviewed status was verified during full-text screening using database indexing information and journal publisher records where necessary. Eligible studies were limited to articles published in peer-reviewed academic journals indexed within the selected electronic databases. Reviews were excluded if they were primary studies, narrative reviews, scoping reviews, rapid reviews, umbrella reviews, protocols, dissertations, conference abstracts, or other forms of non-peer-reviewed literature. 【Study selection】 All retrieved records were imported into Covidence, a systematic review software management. Duplicate records were automatically identified and removed within Covidence. Titles and abstracts were then screened independently by two reviewers (RAA and MKA) against the eligibility criteria. Full-text articles of potentially relevant studies were retrieved and assessed in detail by two reviewers (RAA and MKA). Discrepancies at any stage were resolved through discussion, by a third reviewer (BA). 【Data extraction】 Data extraction was performed using a standardized data extraction form in Microsoft Excel. The form captured bibliographic details such as author, year, and review characteristics including type of review, number of included studies, and databases searched; population characteristics such as age group and diagnosis or risk profile; intervention details including type, mode of delivery, setting, and duration; and reported outcomes relating to effectiveness, accessibility, cost-effectiveness, patient satisfaction, and system-level outcomes. Key findings, conclusions, and identified research gaps were also documented. Data extraction was performed by one reviewer and independently verified by a second reviewer for accuracy and completeness. The characteristics of the included studies are summarized in . Characteristics and key findings of the included systematic reviews. ARMS, At-Risk Mental State; CHEC, Consensus on Health Economic Criteria; CI, confidence interval; cNMA, component network meta-analysis; EIP, Early Intervention in Psychosis; EIS, Early Intervention Services; FEP, First-Episode Psychosis; HTA, Health Technology Assessment; iSMD, indirect standardized mean difference; PIN, Personal Identification Number; QALY, Quality-Adjusted Life-Year; RCT, randomized controlled trial; RoB 2, Risk of Bias 2; RR, risk ratio; SD, standard deviation; SMD, standardized mean difference; TAU, treatment as usual; UHR-T, Ultra-High Risk individuals who subsequently transitioned to psychosis. 【Data synthesis】 The results were synthesized descriptively and presented in both narrative and tabular formats. The synthesis focused on summarizing and comparing findings across included systematic reviews and meta-analyses, identifying common themes, intervention characteristics, implementation factors, and evidence gaps related to early intervention mental health services. Findings were organized across the five pre-specified outcome domains of interest: effectiveness, accessibility, cost-effectiveness, patient satisfaction, and system-level outcomes. Where available, information relating to outcome measures, synthesis approaches, heterogeneity, and sensitivity analyses reported within included meta-analyses was extracted and summarized. Given the rapid review framework and the objective of providing a timely synthesis of higher-level evidence, an independent formal methodological quality appraisal of included reviews using tools such as A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) or the Risk of Bias in Systematic Reviews (ROBIS) was not undertaken. However, risk-of-bias or appraisal information reported within included reviews was extracted where available, and the overall findings should therefore be interpreted cautiously. 【Results】 The study identified 337 studies from the databases searched. The Covidence software automatically screened and removed (87) studies as duplicates. The remaining items (250) were screened against the authors' eligibility criteria based solely on title and abstract, yielding 42 records for full-text screening. The remaining items were full text screened by the two reviewers, and 31 studies were excluded from the records. A total of (11) studies were then eligible for inclusion in this review. The study selection process is presented in . Prisma flow diagram showing results. 【Study characteristics】 Eleven systematic reviews and meta-analyses met the inclusion criteria. The majority were conducted in high-income countries, with five originating in the United Kingdom, three in the United States, two in Australia, and one jointly from the United Kingdom and the Netherlands. Though the