Enhancing Engagement in Health Care: 10 Opportunities by Leo Pas, MD

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Explore 10 key opportunities to improve engagement in health care, focusing on aspects like assessing thoughts, supporting well-being, paying attention to context, and implementing capacity-building strategies. The suggestions include listening to vague signals, empowering client autonomy, and discussing care pathways across sectors. The recommendations emphasize the importance of understanding clients' emotions and behaviors, promoting safety, and fostering multi-sector communication for effective care delivery.

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10 opportunities to engage health care Leo Pas, MD

1) ASK 2) ASSESS THOUGHTS Well fare & Protection sector: Ask & refer Does not work! EVENTS & CON- EMOTIONS SEQUENCES signal Health Care : Leave medical Diagnostic thinking BODILY BEHAVIOR FEELINGS 3) ASSIST Acknowlegde, Advice & Agree 4) ARRANGE Safety & Active follow Up

Health Care: pay more attention to context & vulnerability Donot focus on one medical issue! Minority alcohol Social problems Mental sufffering victimisation or aggression

Ten suggestions to health care 1. Be aware of prevalence of FV and its many presentations 2. Listen to vague indirect signals 3. Focus discussion on violent events (after introduction) 4. Inquire about Ideas , concerns , needs & expectations 5. Consider context complaints (vulnerability,intersectionality) 6. Aim common understanding of thoughts, emotions and behaviors of the client system 7. Empower clients autonomy and coping 8. Audit practice task definitions, distribution and management 9. Discuss and agree carepathway with other sectors 10. Agree on what information to share in both directions

Health care capacity building Based on earlier experiences: IMPLEMENT (WAVE 2015-16) & UNFPA (2014 2015)

Stepped care multi sector communication principles 1. Describe signals 2. Concert with carers in own setting 3. Consult advisory- or reportcenter 4. Discuss ICE IA with client 5. Weigh risk violence 6. Decide how to assist 7. Securing safety 8. And/or report 9. Active Follow-up 10.Arrange protection ASK DISCUSS CONSULT AGREE/ADVICE ASSESS ASSIST: needs & safety REPORT ASSURE FU & SAFETY Adapted from the 'Dutch reporting code'

LEAVE SILLO THINKING 1. 2. t 1. 2. Do not blame your possible partners, but engage in collaboration ! Be aware of different case mix and large grey zone Create space for anonymous advice 24h (?) & urgent (?) Define a consensus based and feasible pathway and casemanagement including Health Care Promote structural embedding of HC in the process & FJC (discuss how) Management Accessibility of services for HCP Tasks distribution and agreement with sectors should includ Health Care Created adequate information channel (what is that ?) Agree sharing information in both directions Make clear rules for confidentiality nd transfer of other information Attendance after referral / non attendance Involved services and further referral Information essential for care Not only intake and release notes Document short and long term protective effects and outcome 3. 4. 5. 6. 7.

2. Be aware of different case mix and large grey zone TOP OF ICEBERG :LAW ENFORCEMENT MIDDLE : SPECIALISED CARE MENTAL CARE BOTTOM : PRIMARYHEALTH CARE &SOCIAL WELFARE

Structure communication 1. 2. 3. 4. 5. 6. 7. Do not blame your HC partners, but engage them in collaboration ! Be aware of different case mix and large grey zone Empower health care services by feedback and support Create space for anonymous advice Develop a consensus based feasible carepathway Promote structural embedding of HC in this process & FJC(possible?) Management Accessibility of services for HCP Tasks distribution and agreement with sectors should includ Health Care Created adequate information channel (what is that ?) Agree sharing information in both directions Make clear rules for confidentiality nd transfer of other information Attendance after referral / non attendance Involved services and further referral Information essential for care Not only intake and release notes 10. Document short and long term protective effects and outcome 24h (?) & urgent (?) 8. 9.

Deal with barriers 1. 2. 3. 4. 5. Do not blame your HC partners, but engage them in collaboration ! Be aware of different case mix and large grey zone Empower health care services by feedback and support Create space for anonymous 24h (?) & urgent (?) advice Define a consensus based and feasible pathway and casemanagement including Health Care Promote structural embedding of HC in the process & FJC (discuss how) Management Accessibility of services for HCP Multi Sectorial protocols should include Health Care Sector Created adequate information channel Agree sharing information in both directions Consensus about confidentiality rules & transfer of information Attendance after referral / non attendance Involved services and further referral Information essential for care Not only intake and release notes 10. Document short and long term protective effects and outcome 6. 7. (use IT?) 8. 9.

Conclusion: 10 opportunities 1. 2. 3. 4. 5. 6. 7. Engage HC in positive collaboration ! Be aware of different case mix Empower health care services Create space for anonymous advice Define a consensus based pathway including Health Care Promote structural embedding of HC Management Accessibility for HCP Tasks agreements should include Health Care Create adequate information channel Agree sharing information in both directions Make clear rules for confidentiality , but always communicate: Attendance after referral / non attendance Involved services and further referral Information essential for care Not only intake and release notes 10. Document short and long term effects 8. 9.