Building Client and Caregiver Engagement Within a Community-Based Mental Health Service for Adults With a Dual Diagnosis

Abstract

Adults with a dual diagnosis (an intellectual disability coexisting with a mental health problem and/or challenging behaviour) have complex health care needs that are often not adequately met by the health care system. Engagement of individuals with an intellectual disability and their caregivers in health care has been highlighted as a critical factor in developing services that better meet client needs; however, very few studies have focused on the engagement of individuals with a dual diagnosis in a health care setting. The overall purpose of this research was to explore the principles and opportunities that can be implemented to build active and meaningful client and caregiver engagement within a specialized community-based mental health service for adults with a dual diagnosis. Individual level and program level services were addressed. This dissertation presents the results of two distinct studies. A participatory action research (PAR) study explored principles and actions that can be applied to build active and meaningful client and caregiver engagement. The four themes that emerged from the PAR study --Collaboration, Communication, Empowering Environment, and Tailored Service -- offered a way to conceptualize client and caregiver engagement. Each of these themes offered practical engagement strategies at the individual service and program service levels. A subsequent proof of concept study offered preliminary evidence for the application of several practical strategies in supporting client and caregiver engagement, with impact at both the personal and practical levels. This research addresses a knowledge gap by providing insights and possibilities for implementing client and caregiver engagement within a specialized community-based mental health service for adults with a dual diagnosis. The engagement strategies have the potential to create future opportunities that can engage, empower, and provide a voice to clients and their caregivers, and positively impact the health care received. Implications for practice, policy, leadership, and future research are provided.