Addressing chronic disease risk factors in people with mental illness
Project title: Community managed organisations: a potential role in addressing the chronic disease burden among people with mental illness
Start date: April 2019
Estimated end date: June 2022
What is the issue?
Few groups experience the burden of chronic disease more than people with mental illness. Worldwide, this high-risk population has a reduced life expectancy of 12 to 30 years. This inequity has a large impact on the overall chronic disease burden, with 45% of the Australian population experiencing mental illness in their lifetime.
There is an opportunity for mental health support services to address the chronic disease risk behaviours of their clients, including smoking, inadequate physical activity, harmful alcohol consumption and poor nutrition. This is recommended internationally, nationally and at state level, but the provision of such preventive care is consistently reported to be sub-optimal. We need to explore additional avenues to provide support to people with mental illness to change their health risk behaviours.
Community managed organisations (CMOs) could possibly help fill this gap as they already play an important role in the care of people with mental illness. CMOs are predominantly not-for-profit or non-government organisations providing support services that help keep people well in the community. There are more than 800 CMOs in Australia providing a diverse range of mental health rehabilitation and support services. We need research to understand what they are doing currently in preventive care, the feasibility or acceptability of CMOs providing preventive care, and the mechanisms that may support CMOs to do so systematically.
How is the project addressing the issue?
We are conducting a scoping and co-design study with CMOs that provide support to people with mental illness in NSW. This involves consumers, care providers and senior managers/executives to co-design a feasible model for the provision of preventive care in CMOs that can be adapted to the resource availability of different service contexts.
What are the expected outcomes?
- A comprehensive picture of the preventive care that is currently being provided by CMOs, the potential barriers, facilitators to its provision, and the mechanisms that could be used to enhance the systematic provision of such care
- A feasible, cost-effective model for the provision of preventive health care for people with mental illness who are receiving treatment through CMOs
- The pilot testing of the model with one large state-wide CMO service during the final year of the project.
Relevance for practice
This project addresses the question of how community managed organisations (CMOs) can help reduce the inequitable burden of chronic disease experienced by people with mental illness; with findings relevant to the policy and practice of both government agencies and CMOs.
A feasible, cost-effective model for the provision of preventive health care for people with mental illness who are receiving treatment through CMOs will be identified, with relevance to CMOs nationally.
Professor Jenny Bowman, University of Newcastle
Professor Andrew Searles, University of Newcastle
Professor Andrew Wilson, University of Sydney
Professor John Wiggers, University of Newcastle
Associate Professor Luke Wolfenden, University of Newcastle
Dr Magda Wilczynska, University of Newcastle
Mental Health Coordinating Council
NSW Mental Health Commission
Funding for this research has been provided from the Australian Government’s Medical Research Future Fund (MRFF). The MRFF provides funding to support health and medical research and innovation, with the objective of improving the health and wellbeing of Australians. MRFF funding has been provided to The Australian Prevention Partnership Centre under the MRFF Boosting Preventive Health Research Program. Further information on the MRFF is available at www.health.gov.au/mrff.
- Over 100 consumers with a lived experience of a mental health condition have participated in the telephone interviews to express their preferences for the delivery of physical health support from community managed organisations.
- Members of staff from two community managed organisations in NSW are currently completing the online staff survey regarding barriers and facilitators to providing physical health support to consumers.
- Data from the qualitative telephone interviews with chief executive officers and senior managers of community managed organisations regarding the types of physical health support their organisation provides is currently being transcribed, reading for analysis.
- A survey to identify current levels of preventive care support being provided to people with a mental health condition is underway with community managed organisations across NSW
- The online survey was informed through key stakeholder review and comment
- More than 50 organisations have completed the survey to date
- The research team has interviewed people with a mental health condition to learn more about chronic disease preventive care at two NSW community managed organisations.
- Consumers from additional CMOs will be recruited to complete further telephone interviews in early 2020
- A survey for NSW CMO staff on chronic disease preventive care is in development for online delivery in early 2020
- The results of the survey to identify preventive care support currently provided to people with a mental health condition in NSW CMOs have been presented at both a national and international conference. These findings will also be shared with survey participants in late 2019.
- Semi-structured key informant interviews have been completed by the leaders of 13 state and national CMOs regarding the preventive care support they provide to people with a mental health condition.
- The results of the survey to identify preventive care support being provided to people with a mental health condition in NSW Community Managed Organisations have been provided to all organisations who took part, as well as to key policy partners such as the NSW Mental Health Commission and Mental Health Coordinating Council of NSW.
- The staff survey about chronic disease preventive care has been amended to include questions about changes to preventive care support following the impact of COVID-19.
- Gibson L, Clinton-McHarg T, Wilczynska M, Latter J, Bartlem K, Henderson C, Wiggers J, Wilson A, Searles A, Bowman J. Preventive care practices to address health behaviours among people living with mental health conditions: A survey of Community Managed Organisations. Preventive Medicine Reports. 2021;23:101495. doi:10.1016/j.pmedr.2021.101495.
- Fehily C, Latter J, Bartlem K, Wiggers J, Bradley T, Rissel C, Reakes K, Reid K, Browning E, Bowman J. Awareness and use of telephone-based behaviour change support services among clients of a community mental health service. Australian and New Zealand Journal of Public Health. 2020 Oct. doi:10.1111/1753-6405.13039
- Fehily C, Hodder R, Bartlem K, Wiggers J, Wolfenden L, Dray J, Bailey J, Wilczynska M, Stockings E, Clinton-McHarg T, Regan T. The effectiveness of interventions to increase preventive care provision for chronic disease risk behaviours in mental health settings: A systematic review and meta-analysis. Preventive Medicine Reports. 2020 May 4:101108. doi: 10.1016/j.pmedr.2020.101108
- Roberts R, Nichols T, Calder R, Harris B, Duggan M, Morgan M et al. Improving health outcomes for people with coexisting mental and physical conditions: an integrated approach. Melbourne: Victoria University. 2019;64. (Mitchell Institute Policy issues paper; 5-2019). Available from: https://research.bond.edu.au/en/publications/improving-health-outcomes-for-people-with-coexisting-mental-and-p
- Gibson L, Clinton McHarg T, Wiggers J, Wolfenden L, Bartlem K, Searles A, Wilczynska M, Bowman J. The potential role of Community Managed Organisations in reducing behavioural risk factors for cancer among people with a mental health condition. Asia-pacific Journal of Clinical Oncology 2019:15(S7):33-34. doi:10.1111/ajco.13256
- Clinton McHarg T, Wiggers J, Wolfenden L, Bartlem K, Searles A, Wilson A, Wilczynska M, Latter J, Gibson L, Bowman J. CMO connect: a role for CMOs in connecting physical and mental health. (Abstract, pg.149-150). In Maylea C, Roberts R, Peters D, editors. Equally Well in Action: Implementing strategies to improve the physical health of people living with mental illness. Proceedings of the First National Equally Well Symposium: Charles Sturt University; 2019. ISBN: 978-1-86-467364-7
- Fehily C, Bartlem K, Wiggers J, Wolfenden L, Regan T, Dray J, Bailey J, Bowman J. Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol. Syst Rev. 2018 Apr 30;7(1):67. doi: 10.1186/s13643-018-0735-4.
- Wynne O, Clinton McHarg T, Gibson L, Wilczynska M, Bartlem K, Fehily C, Wiggers J, Wolfenden L, Searles A, Wilson A, Bowman J. The role of Community Managed Organisations in reducing behavioural risk factors for people with a mental health condition: consumer reported receipt and preferences for care. Australasian Society for Behavioural Health and Medicine (ASBHM) Annual Scientific Meeting, 5-7 February 2020, Sydney, Australia.
- Bartlem K. Panellist, 2019 National Symposium on coexisting mental and physical health conditions, Mitchell Institute, Parliament House, Canberra, 15 October 2019.
- Wynne O, Clinton-McHarg T, Wiggers J, Wolfenden L, Bartlem K, Searles A, Wilson A, Wilczynska M, Gibson L, Bowman J.The potential for community managed organisations to reduce inequity by connecting physical and mental health care. 11th Health Services and Policy Research Conference, Auckland, New Zealand, 4-6 December 2019.
- Gibson L, Clinton-McHarg T, Wiggers J, Wolfenden L, Bartlem K, Searles A, Wilczynska M, Bowman J. The potential role of community managed organisations in reducing behavioural risk factors for cancer among people with a mental health condition. Hunter Cancer Research Alliance Symposium, Newcastle, Australia, 8 November 2019. www.hcrasymposium.com
- View from the peak: A publication from the Mental Health coordinating council, November 2019; page 5. Available from: www.mhcc.org.au/wp-content/uploads/2019/11/VFP_Online_November_2019_20191127.pdf
Snapshot of progress