Best Practices: Best Practices for Improving Engagement of Clients in Clinic Care

Abstract

Mental health clinicians and program administrators must implement effective strategies for engaging and retaining clients in care. At a recent series of forums open to providers from clinics in New York City that was sponsored by the city and state public mental health authorities, high-performing providers described their client engagement strategies. In this column the effective strategies reported are summarized in four areas: the first session, staff training and expertise, productivity measures, and engaging families and support persons. The approaches should be of use to administrators to improve programs' ability to engage and retain clients in community-based clinic care.

Predictors of initiation and engagement in substance abuse treatment among individuals with co-occurring serious mental illness and substance use disorders

“…Such strategies have been found to be effective in increasing substance abuse treatment engagement among individuals with primary SUDs (Comfort, Loverro, & Kaltenbach, 2000; Lash, 1998; Lash & Blosser, 1999) and those with primary SUDs and co-occurring psychiatric disorders (DeMarce et al, 2008). Such strategies have become the standard of care in community mental health systems that serve people with SMI (Smith et al, 2010), and research on their utility in increasing rates of engagement in mental health treatment is promising (see Kreyenbuhl, Nossel, & Dixon, 2009 for a review). However, such procedures are generally not sufficient to promote engagement in either mental health or substance abuse treatment in those with dual SMI and SUDs, who often show high levels of functional impairment and are at greatest risk for treatment dropout (Kreyenbuhl et al, 2009).…”

Engaging consumers in the Australian emergency mental health context: a qualitative perspective from clinicians working in the community

“…Although involving families and other support persons has previously been mentioned as a potential contributor to successful engagement (Smith et al . ), this suggests an alternative approach to engagement when the clinician is unable to establish trust themselves. Reflective of the creativity used by clinicians to encourage engagement, participants identified that other trust networks could be found in family members, as well as in other service providers.…”

“…Positive and meaningful engagement is believed to contribute to improved consumer outcomes, including treatment adherence, and reduced adverse outcomes, such as suicide, violence and hospital admission (Smith et al . ). However, understanding how best to engage remains an elusive challenge (Stanhope et al .…”

“…Trust was also highlighted as a central focus for assertive community treatment staff (Killaspy et al 2009). A supporting study, conducting a series of forums with community care providers in New York, found that having well-trained and supported staff is conducive to positive engagement, with experienced and committed staff being able to more effectively engage and retain consumers (Smith et al 2010). The findings also highlight the importance of the first contact being critical in setting the scene for future engagement, and participants flagged the importance of engaging families and support persons.…”

“…With an estimated one-third of people experiencing severe mental health problems disengaging from the mental health system (Kreyenbuhl et al 2009), engagement is recognised as a crucial component of contemporary mental health practice (Shay 1996, Procter 2008, Barker 2009). Positive and meaningful engagement is believed to contribute to improved consumer outcomes, including treatment adherence, and reduced adverse outcomes, such as suicide, violence and hospital admission (Smith et al 2010). However, understanding how best to engage remains an elusive challenge (Stanhope et al 2009) and much of what is currently known about engagement in mental health practice has been explored outside the emergency context.…”