O'Brien, Aileen, Fahmy, Rana and Singh, Swaran P. (2009) Disengagement from mental health services : a literature review. Social Psychiatry and Psychiatric Epidemiology, Vol.44 (No.7). pp. 558-568. ISSN 0933-7954

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Abstract

This paper reviews the literature on disengagement from mental health services examining how the terms engagement and disengagement are defined, what proportion of patients disengage from services, and what sociodemographic variables predict disengagement. Both engagement and disengagement appear to be poorly conceptualised, with a lack of consensus on accepted and agreed definitions. Rates of disengagement from mental health services vary from 4 to 46%, depending on the study setting, service type and definition of engagement used. Sociodemographic and clinical predictors of disengagement also vary, with only a few consistent findings, suggesting that such associations are complex and multifaceted. Most commonly reported associations of disengagement appear to be with sociodemographic variables including young age, ethnicity and deprivation; clinical variables such as lack of insight, substance misuse and forensic history; and service level variables such as availability of assertive outreach provision. Given the importance of continuity of care in serious mental disorders, there is a need for a consensual, validated and reliable measure of engagement which can be used to explore associations between patient, illness and service related variables and can inform service provision for difficult to reach patients.

Item Type:	Journal Item
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Social Psychiatry and Psychiatric Epidemiology
Publisher:	Dr. Dietrich Steinkopff Verlag
ISSN:	0933-7954
Date:	July 2009
Volume:	Vol.44
Number:	No.7
Number of Pages:	11
Page Range:	pp. 558-568
Identification Number:	10.1007/s00127-008-0476-0
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/27769

Data sourced from Thomson Reuters' Web of Knowledge

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