Cross-agency working when conducting a pragmatic RCT for older victims of crime: our experiences and lessons learned

Background: With the population ageing, more victims of community crime are likely to be older adults. The psychological impact of crime on older victims is significant and sustained, but only feasibility trials have been published regarding potential interventions. The integration of public health and care services and cross-agency working is recommended, but there is little information on how this should be undertaken. Our recent Victim Improvement Package (VIP) randomised controlled trial (RCT) involved cross-agency collaboration between our university, a police service and a mental health charity. However, as the VIP trial only managed to recruit 131 out of 226 participants, we hope our reflections will help those wishing to conduct research in this population. Methods: The trial management group (authors) and partners organisations identified the challenges and lessons learned from conducting the VIP trial in which the police identified and screened victims of reported community crime, aged 65 years or over, for distress. In the VIP trial, three screening methods were used: (1) visits by safer neighbourhood teams (SNTs), (2) police telephone screening and (3) employment of a university researcher embedded within the police service. Staff from the mental health charity were trained to deliver a manualised cognitive-behaviourally informed Victim Improvement Package (VIP) to be compared against treatment as usual (TAU). Lessons learned: Factors promoting successful screening included simple IT systems, building rapport with the police and maintaining contact with participants. However, policy and staff changes within the police service and altered public confidence in the police compromised screening. The delivery of therapy was impaired by waiting times, therapist availability and the quality of therapy. Conducting research within an existing busy clinical service was challenging, but the COVID-19 pandemic demonstrated the acceptability and feasibility of offering online therapy to older victims. Conclusion: SNT screening was an effective way to identify distressed victims, but service demands question whether it is viable for working police staff and the delivery of the therapy proved challenging in the context of a traditional RCT. Ways in which to strengthen research in this pioneering area of work are discussed.