Large amounts of time, effort and money are pumped into strategies to reduce crime in the UK. The research that evaluates these strategies generally focuses on the amount of crime as an outcome, with reduced rates indicative of success. However the effects of crime, and fear of crime, on the health and well-being of the population are generally neglected within the outcome research.

Crime, particularly violent crime, such as assault, can obviously lead to direct effects on physical health. It has been suggested however that crime and the fear of crime can also impact negatively on mental health, physical health (due to limited activity) and social well-being (due to isolation or limited social cohesion).

The authors of the current review (Lorenc et al 2014) aimed to synthesise both quantitative and qualitative evidence on crime, fear of crime, the environment and impacts on health and well-being.

Methods

To identify evidence the authors searched 18 databases, checked reference lists, conducted internet searches and consulted with members of the research team and advisory group. They included 85 studies in the review; 47 in the quantitative and 39 in the qualitative review (1 study was included in both).

The studies selected for the quantitative review were mostly UK studies (n=36, 77%) and included one randomised controlled trial (RCT), 21 non-randomised controlled studies and 25 uncontrolled- before and after studies. Most studies only investigated fear of crime and not health and well-being outcomes. They were also generally rated as low quality (n = 34), and almost half (n=22) did not report any tests of statistical significance. As a result meta-analysis was not conducted, and instead the authors synthesised the studies narratively with the studies categorised into 7 types of intervention.

For the qualitative review the authors used thematic analysis using a grounded theory approach to identify key themes.

Results

Quantitative results

• Home security interventions (n=5): The results indicate that home security improvements can be effective in reducing fear of crime. Two studies measured health outcomes, of which one found no effect and one found a significant reduction in depression and anxiety, in addition to promising findings for social cohesion outcomes.
• Street lighting improvements (n=16): The evidence is mixed; whilst uncontrolled studies show a trend towards reduced fear, controlled studies give less indication that the intervention is effective.
• CCTV (n=6): The data suggest that CCTV in ineffective at reducing fear of crime.
• Multicomponent crime prevention interventions (n=9): There is no strong evidence that these interventions are effective in reducing fear or improving social outcomes. Whilst some suggest positive trends, others show negative trends.
• Housing improvement (n=7): The results are mixed and difficult to interpret. Some studies show a positive trend, however one also shows a substantial adverse effect.
• Regeneration and area based initiatives (n=2): The data is difficult to interpret due to the poor quality of the studies.
• Improvements to public areas (n=2): Interventions to improve the environment may have significant benefits with respect to some fear related outcomes.

Qualitative results

With regards to the consequences of fear of crime on mental health, some participants reported less severe psychological impacts, however only a few participants reported experiencing serious psychological stress as a result of their fear. Those who did typically fell into one of two groups; victims of serious crimes and people who have a pre-existing mental health problem. Rather than mental health impacts, participants were more likely to discuss how fear of crime can limit their everyday activity, social interaction and physical activity; and also how it can affect the restrictions that parents place upon their children.

Conclusion

With regards to fear of crime, the evidence reviewed suggests that most of the interventions are not effective in reducing fear of crime. The evidence is of a fairly low standard; with large variation between the interventions tested, an overall absence of an adequate control group and often incomplete reporting of methods, particularly in relation to the sampling methods. To answer the question with more confidence the authors would need a number of well conducted, high quality RCTs. As only one RCT was found (and even this was only rated as medium quality), it would seem that the evidence is just not available.

The interventions that appear to be the most promising are home security interventions and improvements to public areas, whilst CCTV interventions appear to be the least promising. Interestingly, the interventions that are explicitly directed towards crime reduction seem to be less effective in reducing fear than those not primarily perceived as crime reduction initiatives. Perhaps through raising awareness of crime, fear also increases (although the review did not find any evidence of this). The authors did however suggest that:

there perhaps needs to be a broader recognition that reducing crime and reducing fear of crime may not go hand in hand, and may even conflict.

Only two quantitative studies included mental health outcomes in addition to fear of crime, one showed an improvement in both (Halpern 1995), the other an improvement in fear of crime but not mental health outcomes (Brownsell, Blackburn & Hawley 2008). Furthermore the qualitative evidence seems to suggest that the adverse effects of fear of crime on mental health seem to be confined to victims of crime or those with pre-existing mental health problems. Although the review suggests that fear of crime may impact on well-being in terms of physical activity for example, it adds little to the knowledge of fear of crime in relation to mental health.

Links

Lorenc T, Petticrew M, Whitehead M, Neary D, Clayton S, Wright K, et al. Crime, fear of crime and mental health: synthesis of theory and systematic reviews of interventions and qualitative evidence. Public Health Res 2014; 2(2).

Halpern D. Mental Health and the Built Environment: More than Bricks and Mortar? Abingdon: Taylor & Francis; 1995

Brownsell S, Blackburn S, Hawley MS. An evaluation of second and third generation telecare services in older people’s housing. J Telemed Telecare 2008; 14:8–12.