Psychosocial Participants: Engagement-First Support Matching

Cross-disability coordinators soon realize that the standard playbook for sourcing psychosocial participants is different. The standard three-stage process, needs to criteria to rostering, is dependent on the use of the support once it is created. That's precisely what goes wrong for many who have psychosocial disability. The worker is qualified, the shifts are scheduled, but the participant does not answer the door, not because he or she is ungrateful but because he or she has not yet gained that trust and energy, and the whole setup has developed faster than he or she can accept.

When plans under-spend, the workers move on, and the file shows "participant disengaged", as if this were an attribute of the participant, not a design outcome. The key here is to flip the playbook: engagement is not what happens after the match for psychosocial participants. The criteria for matching is engagement.

What engagement-first matching looks for

Temperament is more important than the list of tasks. The essential skill in this work is not what the worker can do, but how he or she is with people: unhurried, "no big deal" about cancelled shifts, can sit with silence, warm without being intrusive. The following are characteristics to look for in profiles and meet-and-greets. Even if a worker states that they have mental health experience, if they do not appear unhurried, they may be the wrong person.

Interests as the connector. A worker who shares the participant's interest in music, games, football, gardening or another activity provides a reason to open the door, a reason other than being a client. Shared interests are more than a nice-to-have in psychosocial matching. They often make up the whole engagement plan.

Toughness for the long run. The initial period of a psychosocial set up can be short visits, tea, cancelled shifts and non-progress in appearance. This should be known and comfortable to the workers, and fully paid for in a truthful way, not as if it were the 20th week of nothing. To avoid the most common mistake, a good worker who after a month determines that they are not wanted, the coordinator needs to brief the worker for the runway.

The participant's speed as the timing. Begin with what the participant can take on, even if it's just one visit per week, and work up to it as you gain their trust. The plan, if not used, is a problem. The plan, if its supports come more quickly than the participant can handle, is a bigger problem, since it teaches the participant that support equals pressure.

Designing the arrangement around engagement

Establish the review cycle to align with the runway: early review with the participant on how the worker feels for them, not just if shifts occurred, that is, if the worker feels off, it is okay to change workers without drama, since in psychosocial support a failure to fit does not simply signal under-achievement, but confirms the participant's assumption that support is not for him. Ensure that the family and clinical team are kept suitably informed with the permission of the participant, and have agreed beforehand what the worker would do in the event of a no answer door, this is not a question of improvisation, and could be either "leave quietly and text something kind" or "escalate immediately". And fiercely defend continuity once it is established, because each worker change is a zero start of the runway.

All this is non-clinical support, and it must stay that way. The worker's role is to be there, to follow a routine, to return slowly to normal life, and to report on any change if it is problematic without passing judgment, but rather sending it up the agreed-upon escalation line.

How this plays out in practice

Imagine a man in his 40's who has schizophrenia, whose plan has been in place for months, whose funding hasn't been used, and who stopped accepting supports after two visits. An engagement-first restart is different: the coordinator does a shortlist based on temperament, the first meeting takes place in the café instead of his flat, one hour a week is deliberately short, the first slot is cancelled without fuss, and the worker is briefed to be on the runway for three months. By the review, three months in, the café has turned to his kitchen, and his plan is finally being put into action. There was no change in the participant. Eventually, the design came together with him.

Next steps

Look at the participants on your caseload who are under-spending their psychosocial plans, and read through each of the stalled plans one question at a time: was engagement the matching criterion or the hoped-for by-product? Redevelop the ones which were by-products.