Predicting Initial Client Engagement with Community Mental Health Services by Routinely Measured Data

Abstract

Engagement is a determinant of how well a person will respond to professional input. This study investigates whether, in practice, routinely measured data predict initial client engagement with community mental health services. Engagement, problem severity, client characteristics, and duration before the first contact were measured at team entrance with clients (n = 529) of three community mental health teams. Regression analysis was used to predict engagement. Gender, age, referrer, having children, having a partner, and ethnicity showed a minor relationship with engagement. Higher problem severity measured by the team members with the Health of the Nation Outcome Scales, being referred for having psychiatric problems and/or causing severe and long-lasting trouble (as 'assessed' by the often non-professional referrer), and a longer duration between enrollment and the first conversation with a client, were indicative for a lower engagement. The final model explained 19.2 % of the variance in engagement. It can be concluded that initial client engagement with community mental health services can be predicted, in part, by routinely measured data. The findings can be used by community mental healthcare teams to create an awareness system.

Effects on Satisfaction and Service Engagement of Paliperidone Palmitate Compared with Oral Paliperidone in Patients with Schizophrenia: An Open Label Randomized Controlled Trial

“…In addition, they make easier the ongoing relationship and therapeutic alliance between patient and caregivers that is essential for a reliable monitoring of the patient's progress and compliance (51). In patients receiving a treatment with LAIs, the low risk of adverse effects related to stable plasma concentration and the opportunity to avoid taking pills every day may increase social adaptation, autonomy, and sense of self-efficacy (20,52). A relevant consequence is the decrease of stigma associated with schizophrenia.…”

“…The impact of antipsychotic treatment on service engagement of patient is a relatively understudied topic. Engagement is a multi-dimensional concept including not only the compliance to predefined plans, but also the development of trust and the active involvement of patients in their care processes (19,20). In a treatment project oriented to recovery, engagement in treatment interventions is of fundamental importance to achieve this goal (21).…”

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

“…There has been some international research about reasons for disengagement from mental health services [ 12 , 13 , 14 , 15 , 16 ]. For example, an international review of 14 studies that looked at rates of disengagement and characteristics of people who disengage from mental health services [ 12 ] found significant variability in reported rates (4–46%).…”

“…They noted the importance of engagement in the early stages of illness as crucial and also that there has been limited research on the therapeutic alliance between consumers and mental health professionals in relation to disengagement. An international scoping review [ 13 ] similarly proposed that consumers who were more likely to disengage were younger in age, male gender, from ethnic minority background, and with comorbid drug abuse. They also noted consumers’ desire to solve their own problems, dissatisfaction with treatment, inconvenience and practical constraints, and desire for greater control and less coercive interactions with health professionals, perceiving that they no longer needed support or that it was unhelpful.…”

Mental health practitioner experiences of engaging with service users in community mental health settings: A systematic review and thematic synthesis of qualitative evidence

“…Although these authors do not define engagement in explicit terms, the SES focusses on availability (client available for arranged appointments), collaboration (client actively participating in the management of mental health problem), help‐seeking (client seeking help) and treatment adherence (attitude towards taking medication). The SES is a useful, valid and reliable tool for practitioners to identify key areas of concern in terms of service user engagement (Roeg, Goor, & Garretsen, 2015). It is within the broad terms outlined within the SES that the present study should be considered.…”