Engagement with engager: what factors are associated with attendance in a complex intervention for men with common mental health problems, near to and after release from prison

Engager is a complex, collaborative, but flexible intervention providing psychological and practical support to male prison leavers with sentences of two years or less. Engager was not shown to be effective from an evaluation of standard outcome measures, although full delivery of the intervention was also not achieved. The success of interventions relies partly on how able individuals are to attend, so we used an exploratory analysis of the Engager evaluation data to investigate what factors impacted on the extent to which participants attended Engager sessions. The results showed that problems with alcohol at baseline have a positive relationship with subsequent attendance (i.e., predict greater engagement). This finding was somewhat unexpected. Several other factors were found not to be predictive of either increased or decreased attendance, including depression, anxiety and psychological distress. This is a potentially positive finding, in that Engager appears to overcome some barriers to engagement in those with more severe common mental health issues, rather than them engaging less. This is despite previous evidence of these factors reducing attendance for mental health and psychological support. Potential reasons for these findings and implications for future research are discussed.