In this blog, our Data Analyst Keith Gibson shares our learning around factors that contribute to disengagement based on evidence from our programme's direct work with people facing multiple disadvantage.
“I feel like I’m being punished for not engaging”
By Keith Gibson, FLNG Data Analyst
People experiencing multiple and complex needs (MCN) are often referenced as ‘difficult to engage’ or ‘hard to reach’ and a common theme amongst services is inconsistent levels of engagement with the people they support. The learning from our programme’s direct work with people experiencing MCN provided an opportunity to explore some of the factors that contribute to disengagement. In this blog we share some of our findings and consider different approaches services can take to reduce disengagement.
What does disengagement look like?
In practice, disengagement can look like missed appointments, not answering the telephone, changing numbers frequently or a worker receiving no answer when attending the person’s address. Longer term, this can look like the person moving away without a contact telephone number and not being in contact with other services so the worker may find that they have no way to make contact with the person.
Over the course of our programme, we collected people’s service use, periods of disengagement and accommodation changes. We found that 63% of our people did not have a record of disengagement, that is to say reasonably regular contact was maintained with programme staff during their time with us. Of those that did have a disengagement record, we noticed that people disengage for various reasons, regularity and for different lengths of time.
A review of our case notes identified some common themes around people with a disengagement record.
We also noted a significant difference in engagement rates between males and females:
The role of the worker
We carried out interviews with staff to gather views around factors related to disengagement which revealed differences in viewpoints, understanding and professional practice amongst our workforce. Awareness of training specifically related to disengagement was low and could be an area to explore further. A focus group with our Experts by Experience Network of people with lived experience of MCN contributed to this assessment, suggesting that reaching people experiencing MCN requires a person-centred approach to flexibility, intensity of contact, consistency and persistence of approach, and tools to support building a different rapport.
Similarly, through our work with local & regional services and support agencies we recognised that a wide range of viewpoints and practices also exist across services, and not just within each service. The way that some services are commissioned, service pressures and thresholds can mean that they are not able to offer the flexibility or long term support people experiencing MCN can benefit from.
Approaches for services to explore
Good record keeping is essential for understanding the unique circumstances of a person’s patterns of engagement. Even if no contact has been made, keeping a record of attempts to make contact is useful for colleagues and the service in general when considering new strategies to engage or if there is a change of worker.
Co-produced personal engagement plan, bringing the person into the picture early to establish mutual expectations, builds trust and may assist with early engagement. By agreeing to a co-produced reasonable plan of action for disengaged spells, a worker is supported in their actions and the person knows what to expect. For example, one EBE Network member said they would be happy for their peers/other services to be contacted to help re-establish engagement. Exploring people’s preferences can help build trust, and by addressing barriers that reinforce further disengagement (i.e. guilt and too embarrassed to come back) before they happen we can get people to re-engage at an earlier stage.
Good practice guidelines – Person-centred approaches to engagement and disengagement are advantageous; certainly FLNG staff felt trusted to use their judgement about how and when to re-engage a person. However, our EBE Network described inconsistencies and wide variations across services in terms of rules and also felt rules were unfairly implemented. Good practice guidelines for the implementation and application of rules, in conjunction with a personal engagement plan, could form the basis of addressing disengagement. The differing experiences of males and females who are disengaging is worth exploring further in the development of guidelines and any training for staff.
Ethos – we analysed destination outcomes which showed that engagement does not always predict a positive outcome and disengagement is not necessarily a predictor of a negative outcome. A trauma-informed understanding of what day to day life looks like for people experiencing MCN is essential to understanding disengagement and patterns of engagement generally, as well as understanding the impact of trauma on people’s capacity to engage with the support.
Our learning: a summary
- Men and women engage in different ways.
- Disengagement is not necessarily an identifier of decline.
- Engagement is not necessarily an identifier of improvement.
- Our Experts by Experience Network would like to see changes in how services approach dis/engagement.
- There was a significant variation in understanding, belief and approach to engagement across our FLNG workforce. Understanding this may help other agencies to explore their approaches to variations in engagement.
Find out more
Our Disengagement insights report explores our learning around disengagement in more detail and presents the data behind it, along with case studies illustrating different experiences of disengagement. Please also get in touch with me by email at firstname.lastname@example.org if you have any questions.