Essential ingredients of engagement with community mental health services: A qualitative meta-synthesis
Poster B137, Friday, October 21, 11:30 am - 1:00 pm, Le Baron
Rachel Tindall1,2, Kelly Allott2, Magenta Simmons2, Bridget Hamilton1; 1The University of Melbourne, Department of Nursing, 2Orygen, The National Centre of Excellence in Youth Mental Health
Disengagement from community mental health services is common, resulting in unplanned treatment cessation and poor health outcomes. One of the aims of developing early intervention (EI) services for young people was to address this population’s poor engagement with traditional mental health services. However, EI disengagement rates parallel those of traditional services. It is therefore of utmost importance to understand how to better engage people who have mental ill health with mental health services. Qualitative research approaches have been used in diverse settings to investigate the complex personal, interpersonal and social experiences of people as they engage and disengage with mental health services. We therefore conducted a systematic review and qualitative meta-synthesis of 17 studies that explored engagement from the perspectives of clients and case-managers. Two processes of engagement were described in the studies (initial and maintained engagement). The client, family or caregivers, clinicians and services all have a vested interest in a person’s engagement with mental health services. Each of these stakeholders also have different roles and responsibilities in establishing and maintaining engagement. This review identifies a subset of skills that can be used by each stakeholder to improve engagement and prevent disengagement. These include addressing stigma, focusing on the therapeutic relationship and addressing basic needs, such as accommodation, education or finances, alongside management of symptoms and risk. There is a critical need to stimulate further discussion around disengagement, therefore this review can also act as a guide for further research in this critical area.
Topic Area: Psychosocial Interventions