The information in this report is based on a fascinating expert listening session that took place in Fall, 2015, along with interviews of key informants, many of whom are quoted in the report.

Many people who seek mental health care drop out, and 70% of those dropping out do so after a first or second visit.   As the report shares, there are many reasons this happens, but the focus of this report is on relationships between people with mental illness and service providers, their families, and the community as a whole.

Although diverse views were expressed at the listening session, one common theme emerged.   As a society, we can do far better engaging people with mental illness, particularly at times when help, support and compassion are most needed.   We heard many stories about lost opportunities for engagement, sometimes with horrific consequences.  And, we heard that if we want to improve the lives of people with mental illness and their families, we must shift to a culture that embraces engagement as a new standard of care.

All is not bleak by any means.  In the course of our research for this report, we heard some shining examples of successful efforts to engage people, even those who may be difficult to engage due to severity of symptoms or lack of insight.

The report sets forth principals for advancing a culture of engagement in mental health care, including:

• Communicating hope rather than hopelessness;
• Supporting individuals, whenever possible, to be active participants in their own care;
• Focusing on the strengths of individuals rather than their deficits;
• Including family and other close supporters as essential partners in care and recovery; and
• Recognizing the role of community, culture, faith, sexual orientation and gender identity, age, language and economic status in recovery.

The report is based on the premise that these principals of engagement should be ingrained in all services and supports provided to individuals and families.   The report includes examples of promising engagement practices and programs.

Engagement is a piece of a complicated puzzle, whether individuals are seeking services and supports for the first time or have experienced mental illness for many years and have cycled in and out of homelessness, emergency rooms and correctional settings.   However, it is a very important piece of the puzzle, one that if implemented can help change the culture of mental health care in America.

A copy of the report is attached.   The report and related information can also be found and downloaded at www.nami.org/engagement.

This report is a first step in NAMI’s ongoing work on engagement.   We welcome your feedback on the report and on engagement in general.   Please send feedback to policy@nami.org.

Ron Honberg, J.D. Senior Policy Advisor Advocacy & Public PolicyNAMI, National Alliance on Mental Illness 3803 N. Fairfax Dr., Suite 100 Arlington, VA 22203 Main: 703-524-7600 Direct: 703-516-7972