Australian Mental Health Consumers’ Experiences of Service Engagement and Disengagement: A Descriptive Study

Abstract

Mental health issues are a severe global concern with significant personal, social, and economic consequences and costs. This paper reports results of an online survey disseminated across the Australian community investigating why people with mental health issues choose particular mental health services over others, what causes them to disengage from services, and what factors and qualities of services are important to consumers to support their continued engagement or re-engagement with mental health services. The importance of GPs was evident, given their key role in providing mental healthcare, especially to those referred to as “the missing middle”—consumers with mental health issues who fall through the gaps in care in other parts of the healthcare system. The study found that many respondents chose to engage with mental healthcare providers primarily due to accessibility and affordability, but also because of the relational qualities that they displayed as part of delivering care. These qualities fostered consumers’ sense of trust, feeling listened to, and not being stigmatized as part of help seeking and having their mental health needs met. Implications for education and practice are offered.

Working towards the Active Participation of Underrepresented Populations in Research: A Scoping Review and Thematic Synthesis

“…Only engaging with "participants" already aligned with a service raises questions of how representative these samples are for truly disengaged people [36]. Reasons why people may not (or cannot) engage in the research or services are multiple and overlapping and relate to the social determinants of health and the powerful efects they have on precarity [67,68]. Te onus is on the researcher to respect individual agency in engagement, and to critically investigate opportunities to create equity in participation.…”

Measuring Engagement with Mental Health and Behavior Change Interventions: an Integrative Review of Methods and Instruments

“…Questionnaire-based measures can be used to assess behavioral, cognitive, and affective dimensions of engagement. Fourteen studies made use of questionnaires to measure engagement [1,31,36,[40][41][42][43][44][45][46][47][48][49][50]. Questionnaires assessing engagement come in different forms, for example, self-report questionnaires, observer-report questionnaires, or ecological momentary assessments (EMAs) [19].…”

“…Qualitative measures allow for an in-depth assessment of behavioral, cognitive, and affective dimensions of engagement. Eight studies used qualitative measures to measure engagement [38,49,50,[60][61][62][63][64]. The use of qualitative data is especially suitable for assessing out-of-session effort and the dynamic change of overall engagement over time [19].…”

Nurses' experiences when conducting the mental state examination (MSE): A scoping review

“…The lack of involvement perpetuated feelings of disempowerment, dehumanization (Akther et al, 2019) and a desire to re‐engage with the interview assessment process to either seek clarifications about what was discussed, express their thoughts in a different way, or seek a different outcome (Hird, 2007). Lived experiences of mental health assessments have been described by consumers as ‘being stopped in the street by a market researcher, oh answer these questions and goodbye’ (Hird, 2007, p. 1568) including ‘not being listened to’, lack of involvement in ‘decision making’, lack of ‘trust… epistemic trust’ and absence of therapeutic alliance (Lawn et al, 2021, p. 8).…”