Addressing chronic disease risk factors in people with mental illness

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 did the project address the issue?

We conducted a scoping and co-design study with CMOs that support people with mental illness in NSW. This involved working with consumers, care providers, senior managers and 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.

The project team included consumer representatives from the Mental Health Coordinating Council and NSW Mental Health Commission.

What were the outcomes?

• A comprehensive picture of the preventive care currently provided by CMOs, the potential barriers, facilitators to its provision, and the mechanisms that could help enhance the systematic provision of such care
• A feasible, cost-effective model for the provision of preventive health care for people with mental illness receiving treatment through CMOs
• A pilot test of the model with one large state-wide CMO service.

What is the relevance for practice?

This project addressed the question of how 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.

It identified a feasible, cost-effective model for the provision of preventive health care for people with mental illness receiving treatment through CMOs that has relevance to CMOs nationally.