Engagement, Disengagement and Re-Engagement in MentalHealth Services Among Young Patients With First-EpisodePsychosis: A Scoping Review
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Date
2025-09-18
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Publisher
Wiley
Abstract
Introduction: Engagement in mental health services among young patients with first-episode psychosis (FEP) is crucial for pre-
venting relapse. We conducted this scoping review to establish the proportion and determinants of engagement, disengagement
and re-engagement in outpatient mental health care among young patients from 13 to 35 years with FEP.
Methods: We used the guidelines for scoping review by the Joanna Briggs Institute (JBI) and the Arksey and O'Malley frame-
work. We searched for published and unpublished studies guided by the inclusion criteria: studies published in English from
1990, the expansion of psychiatric outpatient, focused on engaged, disengaged and re- engaged in outpatient mental health care
using quantitative, qualitative and mixed methods studies. We performed the numerical and thematic analysis and reporting
using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for scoping review (PRISMA-ScR).
Results: About 25 articles published from 2002 to 2020 met the inclusion criteria for this review; the proportion of young peo-
ple with FEP who remained engaged was 45.5% for 6 months of follow-up, and the proportion of re-engagement after initial
disengagement was 78.8%. Disengagement ranged between 13% and 56.3% for 12–36 months. The socio-demographic factors
associated with disengagement were older age, male, black, unmarried status, living alone, unemployment, social and material
deprivation, poverty, substance use and involvement with criminal justice. Some clinical determinants included a history of
mental illness in the family and a psychosis disorder diagnosis other than schizophrenia.
Conclusion: Disengagement from mental health services is consistently high among people with FEP, indicating the need for
intervention studies that address the associated individual and clinical factors to ensure their retention in treatment.
Description
Keywords
Mental Health Services, Engagement, Disengagement
Citation
Mlay, J., Paruk, S., Tomita, A. and Lessells, R., 2025. Engagement, Disengagement and Re‐Engagement in Mental Health Services Among Young Patients With First‐Episode Psychosis: A Scoping Review. Early Intervention in Psychiatry, 19(10), p.e70100.