Archived: Addressing mind and body in mental health services
After 10 years studying the care provided to address chronic disease risks for people with a mental illness, health psychologist Jenny Bowman has launched a Prevention Centre research project that aims to work with community mental health services to address the significant physical health issues of their clients.
Associate Professor Bowman, of the School of Psychology at the University of Newcastle, said people with mental illness were more likely to die prematurely from cancer, heart disease or respiratory disease. This was partly because they engaged in a higher level of lifestyle risk factors such as smoking, poor nutrition and lack of physical activity.
Although mental health services often have policies around screening for health risk behaviours, she said it was difficult to overcome a history which had often seen the care for mental and physical health issues provided in a siloed fashion – with different services and clinicians taking responsibility for one, or the other, but rarely seeing a role in addressing both.
“There is clearly a role for health services to be taking a more holistic approach and a need to identify mechanisms that can support them to do so,” Associate Professor Bowman said.
The new project, Translation of preventive care guidelines into community mental health service delivery, will test the effectiveness of locating a designated preventive care practitioner to address chronic disease risks in a community mental health service in a Hunter New England Local Health District in NSW.
Over six months, about 500 clients will be randomly allocated to receive usual care, or usual care plus a 40-minute appointment with the preventive practitioner, who will do a risk assessment and motivate clients to make a change. Clients will be referred to services such as the Quitline and the NSW Get Healthy Service, and provided with follow-up phone support.
The research will measure how many clients take up the referrals, as well as their satisfaction with the services they receive.
Associate Professor Bowman said that if the model of care was shown to be effective, it could increase the delivery of preventive healthcare in mental health services nationally and internationally.
She said there had traditionally been some reluctance to address risky health practices in clients with a mental illness, due to beliefs such that changing behaviours such as smoking could exacerbate their mental illness. However, there was strong evidence that quitting smoking, increasing physical activity and improving nutrition could also improve mental health.
The research team hopes that addressing chronic disease risk during appointments at the mental health service might be an effective way to remove barriers to healthy practices.
“Mental health clients develop trust and confidence around their mental healthcare providers, and this provides a good opportunity as they are likely to access the service over time,” Associate Professor Bowman said.
For the clients themselves, support in addressing risky health behaviours could prove life-changing,
“We know from previous research that clients do want these issues addressed – they are really important issues for them, but they often don’t feel they have the resources, capacity and support to make a successful attempt to improve their health risk behaviours,” Associate Professor Bowman said.
“When we talk to patients who have been very unwell and smoking for as long as they can remember, they will say in a very heartfelt way this is the first time they have thought they might be able to be a non-smoker. For some people it’s a long time since they have had that sense of empowerment and it’s quite profound.”
- Helen Signy, Senior Communications Officer