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Ngune I, Wynaden D, Heslop K. Physical Health of People with Mental Illness: A Snapshot of Consumer Engagement in the Provision of Care in Primary Care. Issues Ment Health Nurs 2024; 45:429-435. [PMID: 38478474 DOI: 10.1080/01612840.2024.2312180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Primary care is crucial to the health of people with mental illness. However, there is limited information on their reported engagement in this setting. This study surveyed 100 people with mental illness who had a general practitioner or a general practitioner and a case manager from a tertiary mental health service to determine their engagement level with their GP and what interventions they received to manage their health. Forty-four per cent had their psychotropic medications primarily prescribed by their GP, and 58% reported visiting their GP for physical health problems. Ninety-four point nine percent of participants aged 50 years and over had not received government age-recommended preventive health checks. Only 62% of participants reported being screened by their GP for psychotropic side effects. Primary care plays a crucial role in providing physical and mental health care, but service users report gaps in service. The findings suggest a need to support primary care professionals further to coordinate care across primary and secondary care settings.
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Affiliation(s)
- Irene Ngune
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, Western Australia
| | - Dianne Wynaden
- Curtin School of Nursing, Curtin University, Bentley, Western Australia
| | - Karen Heslop
- Curtin School of Nursing, Curtin University, Bentley, Western Australia
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Perry BI, Mitchell C, Holt RI, Shiers D, Chew-Graham CA. Lester positive cardiometabolic resource update: improving cardiometabolic outcomes in people with severe mental illness. Br J Gen Pract 2023; 73:488-489. [PMID: 37884375 PMCID: PMC10617973 DOI: 10.3399/bjgp23x735273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Affiliation(s)
- Benjamin I Perry
- Department of Psychiatry, University of Cambridge; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge
| | | | - Richard Ig Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton
| | - David Shiers
- School of Medicine, Keele University, Keele; Division of Psychology and Mental Health, University of Manchester; Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester
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Chua YC, Abdin E, Tang C. A retrospective database study on 2-year weight trajectories in first-episode psychosis. Front Psychiatry 2023; 14:1185874. [PMID: 37476538 PMCID: PMC10354663 DOI: 10.3389/fpsyt.2023.1185874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/07/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction It is critical to focus on individual weight profiles in line with efforts to tailor treatment, given the heterogeneous nature of the clinical population. This study aims to identify and describe possible two-year weight trajectories among patients accepted to the Early Psychosis Intervention Programme (EPIP) in Singapore. Methods De-identified data was extracted from EPIP's standing database for patients accepted from 2014 to 2018 with a schizophrenia spectrum disorder. Data collected at fixed time-points (baseline, 1-year, and 2-year) included anthropometric measures (height and weight), and sociodemographic (age, sex, highest education level, and vocational status) and clinical (duration of untreated psychosis, number of inpatient admissions, and scores on the Positive and Negative Syndrome Scale and Global Assessment of Functioning) information. Results A total of 391 complete data sets were included for main analyses. Those with missing weight data were more likely to be males, older at baseline, have a highest education level of tertiary and above at baseline, and have a longer duration of untreated psychosis. The weight change across two years resulted in the following membership breakdown: 151 (38.6%) in super high risk; 133 (34.0%) in high risk mitigated; 17 (4.3%) in at risk; 34 (8.8%) in delayed risk; and 56 (14.4%) in low risk. Discussion The lack of pharmacological, dietary, and physical activity data is a significant limitation in this study; however, the results reinforce the justification for future studies to prospectively capture and examine the influence of these data, with the aim of early detection and weight intervention for high risk groups.
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Affiliation(s)
- Yi Chian Chua
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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Czosnek L, Rosenbaum S, Rankin NM, Zopf EM, Cormie P, Herbert B, Richards J. Implementation of physical activity interventions in a community-based youth mental healthcare service: A case study of context, strategies, and outcomes. Early Interv Psychiatry 2023; 17:212-222. [PMID: 35766548 PMCID: PMC10947482 DOI: 10.1111/eip.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/30/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
AIMS Physical activity interventions are recommended for community-based youth mental health services to prevent physical health disparities. Implementation is challenging, and studies focusing on the methods to achieve change are needed. This study aims to identify the context, implementation strategies, and implementation outcomes that illustrate how physical activity interventions were implemented within an early intervention service in Australia. METHODS A theoretically informed case study was undertaken. Data from a community-based youth mental health service that delivers an early psychosis programme were collected between July and November 2020. Three data sources were accessed (1) interviews with service managers, mental health clinicians and exercise physiologists; (2) document review of organizational policies and procedures; and (3) survey using the Program Sustainability Assessment Tool. The implementation outcomes investigated were acceptability, fidelity, penetration, and sustainability. Framework analysis was used, and a logic model developed guided by an established template, to interpret findings. RESULTS Forty-three contextual factors and 43 implementation strategies were identified. The data suggests that creating a new clinical team and auditing and feedback are critical for implementation. High levels of acceptability and sustainability were described, while fidelity of implementation was difficult to establish, and penetration was low. CONCLUSIONS The relationship between constructs suggests several mechanisms underpinned implementation. These include changing professional beliefs, establishing new organizational norms, augmenting existing work processes, and aligning physical activity with priorities of the mental healthcare system and existing work tasks. This case study provides direction for future health service planning of physical activity interventions in community-based youth mental health service.
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Affiliation(s)
- Louise Czosnek
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneAustralia
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental HealthUniversity of New South WalesSydneyAustralia
- School of Health SciencesUniversity of New South WalesSydneyAustralia
| | - Nicole M. Rankin
- Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia
| | - Eva M. Zopf
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneAustralia
- Cabrini Cancer InstituteThe Szalmuk Family Department of Medical Oncology, Cabrini HealthMelbourneAustralia
| | - Prue Cormie
- Peter MacCallum Cancer CentreMelbourneAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneAustralia
| | | | - Justin Richards
- Faculty of HealthVictoria University of WellingtonWellingtonNew Zealand
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Gossip K, John J, Comben C, Page I, Erskine HE, Scott JG, Diminic S. Key service components for age-appropriate mental health service planning for young adults. Early Interv Psychiatry 2022; 16:1085-1093. [PMID: 34821037 DOI: 10.1111/eip.13253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/29/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022]
Abstract
AIM To identify and describe key service components that should be incorporated into age-appropriate integrated mental health care for young adults aged 18-24 years. METHODS Key service components were identified through a mixed-methods approach including targeted examinations of the literature and structured discussions with experts in youth mental health. RESULTS Seven key components were identified as important for providing age-appropriate mental health care to young adults. Two were classified as clinical service components (structured psychological therapies; care coordination and liaison), three were classified as non-clinical service components (vocational support; youth development; peer support) and two as integrated non-clinical and clinical service components (lifestyle interventions and family and network support). Example service models for each of these key service components were identified and described. CONCLUSIONS This is the first study to identify and describe key service components for age-appropriate mental health care for young adults. The findings provide mental health service planners with a framework of services that should be considered when planning and resourcing services for this age range.
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Affiliation(s)
- Kate Gossip
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Julie John
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Charlotte Comben
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Imogen Page
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Holly E Erskine
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - James G Scott
- Mental Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Metro North Mental Health Service, Herston, Queensland, Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
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Williams R, Natkulasingam S, Tooke B, Webster E, Quirk A, Gupta V, French P, Smith J, Crawford MJ. Examining the effects of national initiatives to improve the physical health of people with psychosis in England: secondary analysis of data from the National Clinical Audit of Psychosis. BJPsych Bull 2022; 46:140-147. [PMID: 33949302 PMCID: PMC9347478 DOI: 10.1192/bjb.2021.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS AND METHODS To examine whether national initiatives have led to improvements in the physical health of people with psychosis. Secondary analysis of a national audit of services for people with psychosis. Proportions of patients in 'good health' according to seven measures, and one composite measure derived from national standards, were compared between multiple rounds of data collection. RESULTS The proportion of patients in overall 'good health' under the care of 'Early Intervention in Psychosis' teams increased from 2014-2019, particularly for measures of smoking, alcohol and substance use. There was no overall change in the proportion of patients in overall 'good health' under the care of 'Community Mental Health Teams' from 2011-2017. However, there were improvements in alcohol use, blood glucose and lipid levels. CLINICAL IMPLICATIONS There have been modest improvements in the health of people with psychosis over the last nine years. Continuing efforts are required to translate these improvements into reductions in premature mortality.
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Affiliation(s)
- Ryan Williams
- Royal College of Psychiatrists, UK.,Imperial College London, UK
| | | | | | | | | | | | - Paul French
- Royal College of Psychiatrists, UK.,University of Liverpool, UK
| | - Jo Smith
- Royal College of Psychiatrists, UK.,University of Worcester, UK
| | - Mike J Crawford
- Royal College of Psychiatrists, UK.,Imperial College London, UK
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Hui TT, Garvey L, Olasoji M. Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review. Int J Ment Health Nurs 2021; 30:1498-1524. [PMID: 34390119 DOI: 10.1111/inm.12922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 12/01/2022]
Abstract
People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25 years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra-high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first-line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first-episode psychosis and those who are at ultra-high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty-two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co-designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co-designed lifestyle intervention for the targeted population.
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Affiliation(s)
- Ting Ting Hui
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia
| | - Loretta Garvey
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia
| | - Michael Olasoji
- Department of Nursing & Allied Health, School of Health Sciences, Swinburne University of Technology Australia, Hawthorn, Victoria, Australia.,School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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