The VIP trial: a randomised controlled trial of the clinical and cost effectiveness of a Victim Improvement Package (VIP) for the reduction of chronic symptoms of depression or anxiety in older victims of common crime
A police-led screening programme will identify older victims of crime who develop depression or anxiety, then offer them up to ten sessions of cognitive behavioural therapy delivered by a mental health charity. Crime victims over 65 are at high risk of developing chronic mental health problems, yet they often fall through gaps between police, GPs, and mental health services. Standard care—signposting to voluntary agencies or a GP—rarely provides the structured psychological support this group needs. The trial tests whether a coordinated package of screening, referral, and manualised therapy can close that gap. If the Victim Improvement Package proves effective and cost-effective, it could change how police and health services respond to older crime victims across the UK. Rather than leaving them to navigate fragmented support alone, the approach would embed mental health triage into routine police contact, then link directly to therapy. This could reduce long-term distress, cut NHS costs from untreated depression and anxiety, and give older victims a practical route to recovery that currently does not exist.
View original technical description
Research question: for victims of common crime, aged 65 years or more, does the addition of a Victim Improvement Package (VIP) to treatment as usual (TAU), which includes screening and signposting, reduce significant chronicity of depressive and/or anxiety symptoms compared to TAU alone? Methods: Design: a 3 step process; step 1: screening and signposting; step 2: rescreening; step 3: diagnosis and a parallel, assessor blind randomised controlled trial. Setting: Residents of 12 London boroughs, screened for depression and/or anxiety(1,2) by Metropolitan Police Safer Neighbourhood Teams (SNTs) within 2 months of reported crime and signposted where relevant. Potential cases will be re-screened at 3 months post crime to determine trial eligibility. Participant eligibility for RCT: Inclusion criteria: Victims of crime, 65 years or more, screen positive for depression (with or without anxiety). Exclusion: criteria: pre-existing mental illness; current alcohol/drug dependency; recent receipt of Cognitive Behaviour Therapy (CBT); inability to communicate in English; significant memory impairment indicated by Mini Mental State Examination. The intervention being evaluated: A cross-service collaborative approach to identify, assess and refer participants for computerised randomisation, stratified by diagnosis, by an independent CTU, to either the VIP (plus TAU) or TAU alone. I. The intervention: The VIP (added to TAU) consists of: up to 10 sessions of a developed and tested manualised individual therapy informed from CBT, delivered, over 3 months. Delivery: Mind CBT therapists in a non NHS setting. Source of funding: NIHR PHR for the research and Mind for the therapists. II. The comparator: TAU, which includes screening and signposting, consists of routine support, referral to voluntary agencies, the GP, rarely Stress Disorder Clinics or Improving Access to Psychological Therapies. Many older people are reluctant to take psychotropics, but for ethical reasons these will not be discouraged. Assessment of 1 in 10 audio recordings of therapy sessions will enable (i)assessment of quality of therapy using the Cognitive Therapy Scale-Revised(4) (ii)adherence to the VIP manual. Measurement of outcomes and costs: we will record: demographic and clinical information; type of crime and context; data on vulnerability factors e.g. recent life events, participants’ view of available support. Primary: the Beck Depression Inventory-II (BDI-II;6) and Beck Anxiety Inventory (BAI;7) for those diagnosed with depression and anxiety respectively. Secondary: DSM-IV caseness(3); the EuroQol(8) a generic utility measure of quality of life. Mixed methods to explore signposting (i) Quantitative: if and how people have acted on the signposting. (ii) Qualitative: semi-structured interviews. Economic: a modified version of the Client Service Receipt Inventory(9) to collect economic data. Sources of bias: measures of: attrition and engagement with therapy: drop outs, illness, death, did not attend rates; potential systematic biases: participants’ group preference, belief in the treatment, assessment of “blindness”; prescribed psychotropic medication; other psychological treatments received; measures of fidelity to treatment; measures of satisfaction for the treatment. Researchers will collect data: 3 months post crime (baseline); 6 months post crime (primary endpoint/post-intervention); 9 months post crime (followup)
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know