ReviewSocial psychiatry and psychiatric epidemiology2009
Disengagement from mental health services. A literature review.
Review in Social psychiatry and psychiatric epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 6 syntheses or guidelines pooled it, 283 citations in OpenAlex.
- Analyzing the Placebo Response and Identifying Influential Factors in Oral Medication Trials for Acute-Phase Schizophrenia.Schizophrenia bulletin · 2026Pooled it
- Barriers and facilitators to engagement in psychological therapy in first episode psychosis: A meta-ethnography and qualitative comparative analysis.Psychology and psychotherapy · 2025Pooled it
- Patient safety incidents in the psychiatric inpatient setting: determinants, consequences, and strategies. A systematic review.Frontiers in psychiatry · 2025Pooled it
- Defining disengagement from mental health services for individuals experiencing first episode psychosis: a systematic review.Social psychiatry and psychiatric epidemiology · 2019Pooled it
- Pooled it
- Measures of the recovery orientation of mental health services: systematic review.Social psychiatry and psychiatric epidemiology · 2012Pooled it
- Engagement with a digital therapeutic for smoking cessation designed for persons with psychiatric illness fully mediates smoking outcomes in a pilot randomized controlled trial.Translational behavioral medicine · 2021Trial
- Computerized cognitive training is associated with improved psychosocial treatment engagement in schizophrenia.Schizophrenia research · 2018Trial
- Trial
- Person-centered care planning and service engagement: a study protocol for a randomized controlled trial.Trials · 2015Trial
- Characteristics of community mental health clinics associated with treatment engagement.Psychiatric services (Washington, D.C.) · 2014Trial
- Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.Journal of consulting and clinical psychology · 2014Trial
- Measuring participation in an evidence-based practice: illness management and recovery group attendance.Psychiatry research · 2013Trial
- Predictors of initiation and engagement in substance abuse treatment among individuals with co-occurring serious mental illness and substance use disorders.Addictive behaviors · 2011Trial
- Client Engagement With an Early Psychosis Program and Post-Program Health Service Use: A Retrospective Cohort Study.Early intervention in psychiatry · 2026Article
- Patient engagement and connection to care in a telehealth behavioral health crisis care program: an implementation evaluation.BMC health services research · 2026Article
- Game Changers in the Treatment of and Engagement With Persons Living With Mental Health and Substance Use Disorders: The Role of the Nurse.International journal of mental health nursing · 2026Review
- Article
- Case Managers' Experiences of Engagement With Service Users in UK Early Intervention Services for First-Episode Psychosis: A Hermeneutic Interpretive Phenomenological Analysis Study.Early intervention in psychiatry · 2025Article
- Engage? Disengage? Discharge? Ethical approaches to fraught questions.BJPsych bulletin · 2025Review
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.