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Strunz M, Jiménez NP, Gregorius L, Hewer W, Pollmanns J, Viehmann K, Jacobi F. Interventions to Promote the Utilization of Physical Health Care for People with Severe Mental Illness: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:126. [PMID: 36612457 PMCID: PMC9819522 DOI: 10.3390/ijerph20010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The main contributor to excess mortality in severe mental illness (SMI) is poor physical health. Causes include unfavorable health behaviors among people with SMI, stigmatization phenomena, as well as limited access to and utilization of physical health care. Patient centered interventions to promote the utilization of and access to existing physical health care facilities may be a pragmatic and cost-effective approach to improve health equity in this vulnerable and often neglected patient population. OBJECTIVE/METHODS In this study, we systematically reviewed the international literature on such studies (sources: literature databases, trial-registries, grey literature). Empirical studies (quantitative, qualitative, and mixed methods) of interventions to improve the utilization of and access to medical health care for people with a SMI, were included. RESULTS We identified 38 studies, described in 51 study publications, and summarized them in terms of type, theoretical rationale, outcome measures, and study author's interpretation of the intervention success. CONCLUSIONS Useful interventions to promote the utilization of physical health care for people with a SMI exist, but still appear to be rare, or at least not supplemented by evaluation studies. The present review provides a map of the evidence and may serve as a starting point for further quantitative effectiveness evaluations of this promising type of behavioral intervention.
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Affiliation(s)
| | | | - Lisa Gregorius
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Walter Hewer
- Klinikum Christophsbad, 73035 Göppingen, Germany
| | | | - Kerstin Viehmann
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Frank Jacobi
- Psychologische Hochschule Berlin, 10179 Berlin, Germany
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2
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Happell B, Warner T, Waks S, O'Donovan A, Manning F, Doody R, Greaney S, Goodwin J, Hals E, Griffin M, Scholz B, Granerud A, Platania-Phung C, Russell S, MacGabhann L, Pulli J, Vatula A, van der Vaart KJ, Allon J, Bjornsson E, Ellilä H, Lahti M, Biering P. Something special, something unique: Perspectives of experts by experience in mental health nursing education on their contribution. J Psychiatr Ment Health Nurs 2022; 29:346-358. [PMID: 34032356 DOI: 10.1111/jpm.12773] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/01/2021] [Accepted: 05/13/2021] [Indexed: 12/17/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT ●Expert by Experience participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal. ●Involving mental health Experts by Experience in the education of nursing students demonstrates positive attitudinal change. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE ●The paper presents perspectives from Experts by Experience about the unique knowledge and expertise they derive from their lived experience of mental distress and mental health service use. As a result, they can make a unique and essential contribution to mental health nursing education. They utilize this knowledge to create an interactive learning environment and encourage critical thinking. ●The international focus of this research enriches understandings about how Experts by Experience might be perceived in a broader range of countries. WHAT ARE THE IMPLICATIONS FOR PRACTICE ●Mental health policy articulates the importance of service user involvement in all aspects of mental health service delivery. This goal will not be fully achieved without nurses having positive attitudes towards experts by experience as colleagues. ●Positive attitudes are more likely to develop when nurses understand and value the contribution experts by experience bring by virtue of their unique knowledge and expertise. This paper provides some important insights to achieving this end. ABSTRACT Introduction Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. Aim To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. Methods Qualitative exploratory research methods were employed. In-depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. Results Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. Conclusions These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. Implications for Practice Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, Hunter Institute of Medical Research, Priority Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Terri Warner
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,ACT Mental Health Consumer Network, Canberra, ACT, Australia
| | - Shifra Waks
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rory Doody
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Sonya Greaney
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Brett Scholz
- ANU Medical School, College of Health and Medicine, The Australian National University, Woden, Canberra, ACT, Australia
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Chris Platania-Phung
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Liam MacGabhann
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Jarmo Pulli
- Department of Nursing Science, Faculty of Medicine, Turku University of Applied Sciences, Turku University, Turku, Finland
| | - Annaliina Vatula
- Department of Nursing Science, Faculty of Medicine, Turku University of Applied Sciences, Turku University, Turku, Finland
| | | | - Jerry Allon
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Heikki Ellilä
- Department of Nursing Science, Faculty of Medicine, Turku University of Applied Sciences, Turku University, Turku, Finland
| | - Mari Lahti
- Department of Nursing Science, Faculty of Medicine, Turku University of Applied Sciences, Turku University, Turku, Finland
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
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3
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Bos D, Gray R, Meepring S, White J, Foland K, Bressington D. The Health Improvement Profile for people with severe mental illness: Feasibility of a secondary analysis to make international comparisons. J Psychiatr Ment Health Nurs 2022; 29:86-98. [PMID: 33655576 DOI: 10.1111/jpm.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/05/2020] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates. No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: It appears feasible to use the HIP to profile and compare physical health-related risks in people with SMI across different international settings. The HIP tool identified significant differences in areas of risk across the four countries. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The HIP could be used to identify unique clusters of health promotion needs in different countries. Use of HIP health checks may support implementation of individualized interventions. ABSTRACT: Introduction To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi-national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources.
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Affiliation(s)
- Dawn Bos
- School of Nursing, Winona State University, Rochester, MN, USA
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | | | - Jacquie White
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Kay Foland
- School of Nursing, South Dakota State University, Brookings, SD, USA
| | - Daniel Bressington
- College of Nursing & Midwifery, Charles Darwin University, Darwin, NT, Australia
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Suggett J, Foster K, Lakra V, Steele M, Furness T. Natural cause mortality of mental health consumers: A 10-year retrospective cohort study. Int J Ment Health Nurs 2021; 30:390-400. [PMID: 33035405 DOI: 10.1111/inm.12797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023]
Abstract
People with mental illness have substantially lower life expectancy than the general population, with mortality from natural causes most commonly attributed to cardiovascular diseases. The study aim was to identify characteristics of consumers who died of natural causes between 2009 and 2018 at one of Australia's largest publicly funded mental health services. Data were collected with a retrospective medical record review of 102 consumers. Mean mortality age was 52.4 years (SD = 10.7) (with females 51.9 years [SD = 12.0], and males 52.7 years [SD = 9.9]), which was more than 30 years lower than the Australian population. Cardiovascular diseases were the most frequent mortality cause (39%), followed by respiratory conditions (23%), cancers (20%), and all other causes (19%). Sixty (61%) consumers had at least three co-occurring physical health conditions. Seventy-five (74%) smoked tobacco. Consumers who died from cardiovascular diseases were less likely to attend specialist medical follow-up for their condition (P = 0.004), and more likely to die at home (P = 0.001). Consumers whose mortality age was above 55 years were more likely to have three co-occurring physical health conditions (P = 0.034). Consumers whose mortality age was below 55 years were more likely to have sub-optimal nutritional intake (P = 0.014) and higher body mass index (P = 0.008). There is a critical need to close the life expectancy gap for consumers. This requires dedicated focus on reducing mortality risk due to modifiable clinical characteristics which lead to consumer mortality. Mental health nurses play a key role in helping reduce consumers' mortality and morbidity risk through prevention and early intervention strategies.
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Affiliation(s)
- Joanne Suggett
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kim Foster
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michael Steele
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Trentham Furness
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
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Furzer BJ, Wright KE, Edoo A, Maiorana A. Move your mind: embedding accredited exercise physiology services within a hospital-based mental health service. Australas Psychiatry 2021; 29:52-56. [PMID: 32722965 DOI: 10.1177/1039856220943030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Despite support for the role of exercise in improving physical and mental health for various psychiatric disorders, few service implementation evaluations within diverse hospital environments exist. This study presents the feasibility and implementation of a clinical exercise physiology service within a hospital mental health service. METHOD Feasibility and service data were collected from databases and self-report (consumer and staff) for 6 months from the commencement of new exercise services (gym and group sessions) for community and inpatients (one secure and three open wards). RESULTS One hundred and twenty consumers engaged with exercise services with 70 direct referrals over the 6-month audit period (mean age 40 ± 13 years (19-69); 41% male). The overwhelming reason for referral was related to weight loss/management (65.7%), with the majority of patients (51%) presenting with schizophrenia spectrum and other psychotic disorders. Further, 549 exercise service interactions were delivered and 78% gym attendees and 69% group session attendees rated the exercise sessions as 'Good' or 'Great', and intention to return ranged from 78% for inpatient gym sessions to 91% for community gym sessions. CONCLUSIONS Embedding exercise physiology into a mental health service is feasible and well accepted and the evaluation of long-term consumer outcomes in 'real-world' will serve as a crucial step.
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Affiliation(s)
- Bonnie J Furzer
- School of Human Sciences (Exercise & Sport Science), University of Western Australia, Australia
- Fremantle Hospital Mental Health Service, South Metropolitan Health Service, Australia
| | - Kemi E Wright
- School of Human Sciences (Exercise & Sport Science), University of Western Australia, Australia
- Fremantle Hospital Mental Health Service, South Metropolitan Health Service, Australia
| | - Azam Edoo
- Fremantle Hospital Mental Health Service, South Metropolitan Health Service, Australia
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Australia
- Allied Health Department, Fiona Stanley Hospital, South Metropolitan Health Service, Australia
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6
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Stanley SH, Ferguson L, Harrison L, Martin L, Velayudhan A. The Wellness Clinic: A retrospective Quasi-experimental, longitudinal study of physical health support in an Australian mental health service setting. Int J Ment Health Nurs 2020; 29:1112-1119. [PMID: 32525277 DOI: 10.1111/inm.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
The poor physical health of patients with severe/chronic mental illness is now well-known, yet little has been done to address the issue. Adverse medication effects, lifestyle, and social factors can all contribute to high morbidity and mortality rates when compared to the general population. To arrest poor physical health, a Wellness Clinic within a mental health hospital was developed to provide continuity of care when patients were discharged from the hospital. A retrospective, within-subjects, quasi-experimental, longitudinal time-series study was conducted analysing the demographics and physical health parameters of 57 patients who remained with the service over a four and a half year time period. Assessments were taken at baseline, 12, 24, and 36 months for each individual. Despite increasing levels of psychotropic and other health medication over time, physical health parameters were generally held stable for most measures across the four time periods. HDL-C levels were significantly improved between baseline and 36 months. This stability over time suggests that ongoing assessment, monitoring, and treatment is necessary to arrest the downward trajectory of poor physical health in mental health and opens the door for future research to invest in interventions to run alongside the Wellness Clinic and improve patient physical health.
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Affiliation(s)
- Susanne H Stanley
- Fremantle Hospital Mental Health Service, Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Lucia Ferguson
- Fremantle Hospital Mental Health Service, Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Lauren Harrison
- Fremantle Hospital Mental Health Service, Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Lisa Martin
- Fremantle Hospital Mental Health Service, Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Ajay Velayudhan
- Fremantle Hospital Mental Health Service, Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Fremantle Hospital, Fremantle, Western Australia, Australia
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7
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Stanley SH, Laugharne JDE, Chapman M, Balaratnasingam S. The physical health of Indigenous people with a mental illness in the Kimberley: is ongoing monitoring effective? Australas Psychiatry 2019; 27:358-361. [PMID: 30880407 DOI: 10.1177/1039856219833776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this paper is to evaluate the effectiveness of ongoing physical health monitoring for Indigenous Australians with mental health issues in the Kimberley region of Western Australia. METHOD This longitudinal, within-groups investigation assessed physical health parameters such as blood pressure and blood glucose levels at baseline and at 18 months for the same cohort. No standardised intervention was in place, but action was taken if results were found to be abnormal. RESULTS Most measures of physical health remained stable, with mean lipid and fasting glucose levels remaining abnormal over the entire assessment period. Systolic blood pressure showed a significant improvement. CONCLUSIONS More needs to be done to improve the physical health of Indigenous mental health patients - culturally appropriate and secure interventions incorporating holistic models of care are needed.
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Affiliation(s)
- Susanne H Stanley
- Research Fellow, Division of Psychiatry, UWA Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia
| | - Jonathan DE Laugharne
- Associate Professor of Psychiatry, Division of Psychiatry, UWA Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia
| | - Murray Chapman
- Clinical Director (Mental Health - KMHDS), Associate Professor, FRANZCP Division of Psychiatry, UWA Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA, and; Kimberley Mental Health and Drug Service, Broome, WA, Australia
| | - Sivasankaran Balaratnasingam
- Visiting Psychiatrist, Division of Psychiatry, UWA Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA, and; Kimberley Mental Health and Drug Service, Broome, Fremantle, WA, Australia
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8
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Happell B, Scholz B, Bocking J, Platania-Phung C. Promoting the Value of Mental Health Nursing: The Contribution of a Consumer Academic. Issues Ment Health Nurs 2019; 40:140-147. [PMID: 30763139 DOI: 10.1080/01612840.2018.1490834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mental illness is known to occur frequently in the general population and is more common within the general health care system. High-quality health care requires nurses to have the skills, knowledge and attitudes to provide care for people experiencing mental illness or mental distress. Research suggests health professionals, including nurses, tend to share similar negative attitudes to mental illness as the general population, and consequently, mental health nursing is not a popular career path. These two factors signify a need to influence more positive attitudes toward mental illness and mental health nursing among nursing students. A qualitative exploratory research study was undertaken to examine the experiences, opinions and attitudes of an academic and research team to the introduction of a consumer academic within an undergraduate mental health nursing subject. In-depth interviews were conducted with teaching and research team members. The importance of mental health skills emerged as a major theme and included sub-themes: mental health across the health care system; contribution of consumer academic to nursing skills; addressing fear and stigma, and inspiring passion in mental health nursing. Findings suggest academic input from people with lived experience of recovery from mental illness can influence the development of mental health nursing skills and enhance the popularity of mental health nursing as a career.
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Affiliation(s)
- Brenda Happell
- a School of Nursing and Midwifery, University of Newcastle , Newcastle , New South Wales , Australia
| | - Brett Scholz
- b ANU Medical School, College of Health and Medicine, The Australian National University , Woden , Canberra , Australia
| | - Julia Bocking
- c Consumer Academic , University of Canberra, Faculty of Health, and ACT Health , Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Chris Platania-Phung
- a School of Nursing and Midwifery, University of Newcastle , Newcastle , New South Wales , Australia
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9
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Clancy R, Lewin TJ, Bowman JA, Kelly BJ, Mullen AD, Flanagan K, Hazelton MJ. Providing physical health care for people accessing mental health services: Clinicians' perceptions of their role. Int J Ment Health Nurs 2019; 28:256-267. [PMID: 30152182 DOI: 10.1111/inm.12529] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/16/2018] [Indexed: 11/27/2022]
Abstract
The prevalence of health risk behaviours and associated poor physical health is high in people with severe mental illness. Mental health service guidelines and policies stipulate that mental health services should address physical health of people who access services. This study reports results from a large, interdisciplinary, cross-sectional study exploring mental health clinicians' (n = 385) views of role legitimacy in physical health service provision. All disciplines reported that mental health clinicians have a role to play in addressing the physical health of consumers. Among mental health clinicians, psychiatrists and mental health nurses received higher endorsement than allied health clinicians in relation to the provision of physical health care, with primary care providers including general practitioners also ranking highly. As community mental health services routinely appoint allied health staff to case management roles, a challenge for services and a challenge for clinicians are to ensure that physical health and the effects of medication are monitored appropriately and systematically. Online and telephone support services received relatively lower endorsement. As the availability of nonface to face services increases, there is a need to explore their utility in this population and where appropriate promote their uptake.
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Affiliation(s)
- Richard Clancy
- Hunter New England Mental Health, Callaghan, NSW, Australia.,University of Newcastle, Callaghan, NSW, Australia
| | - Terry J Lewin
- Hunter New England Mental Health, Callaghan, NSW, Australia.,University of Newcastle, Callaghan, NSW, Australia
| | | | | | - Antony D Mullen
- Hunter New England Mental Health, Callaghan, NSW, Australia.,University of Newcastle, Callaghan, NSW, Australia
| | - Karen Flanagan
- Hunter New England Mental Health, Callaghan, NSW, Australia.,University of Newcastle, Callaghan, NSW, Australia
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10
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Furness T, Wallace E, McElhinney J, McKenna B, Cuzzillo C, Foster K. Colocating an accredited practising dietitian to an adult community mental health service: An exploratory study. Int J Ment Health Nurs 2018; 27:1709-1718. [PMID: 29704288 DOI: 10.1111/inm.12470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2018] [Indexed: 11/30/2022]
Abstract
For people with severe mental illness, accredited practising dietitians may assist with a nutrition care plan that considers the medical, psychiatric, psychological, social, spiritual, and pharmacological aspects of their care. However, consumers' access to care has been limited by difficulties attending appointments and suboptimal interface between nutritional and mental health services. Therefore, the objectives of this exploratory study were to describe access to, and key stakeholder perspectives of, the accredited practising dietitian role colocated in a community mental health service. A total of 16 key stakeholders participated in one-to-one interviews. Two main themes with subthemes were derived from analysis of interviews: (i) 'building empowerment and collaboration' and included the subthemes, (a) nutrition awareness and education and (b) healthy lifestyle changes, and (ii) 'overcoming challenges to optimal nutrition and effective health care'. In addition, improved access to the role was demonstrated with 124 (79%) consumers attending at least one appointment with an accredited practising dietitian. A total of 15 (12%) consumers attended more than 10 appointments during their outpatient admission to the community mental health service. Colocating an accredited practising dietitian was perceived to build empowerment and collaboration, and overcome challenges to optimal nutrition and effective health care for consumers, carers, and clinicians. The colocation of a dietitian can empower consumers' to make health-informed decisions and support their willingness to engage with physical healthcare provision when it is prioritized alongside mental healthcare provision.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Elizabeth Wallace
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Jo McElhinney
- NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorne, Victoria, Australia
| | - Celeste Cuzzillo
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
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11
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Settipani CA, Cleverley K, Hawke LD, Rice M, Henderson JL. Essential components of integrated care for youth with mental health and addiction needs: protocol for a scoping review. BMJ Open 2017; 7:e015454. [PMID: 28455426 PMCID: PMC5719660 DOI: 10.1136/bmjopen-2016-015454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Efforts to move towards integrated care have been met with increased interest and enthusiasm in recent years given the potential to improve care and population health while containing costs. However, there is a need to better understand community-based integrated care approaches for youth with mental health and/or addiction concerns to guide future implementation efforts and develop a set of standards for key components. The objectives of this scoping review are to: (1) identify the populations, settings, service providers, interventions, infrastructure and care coordination methods that have been included in integrated care for youth with mental health and/or addiction needs and (2) identify constructs that have been measured and evaluated (eg, outcomes, engagement) in the context of youth integrated care. METHODS AND ANALYSIS Seven electronic databases and several grey literature sources will be searched for material from 2001 to 2016. Inclusion criteria will be broad with respect to type of work, as we will include all types of research studies as well as non-research studies that provide information relevant to characteristics and constructs measured in the context of integrated care for youth mental health. Titles and abstracts will be independently screened for eligibility by two raters using inclusion criteria. Full-text articles will then be accessed and independently screened for inclusion. A formal data extraction method will be employed, enabling synthesis of results in quantitative and qualitative formats. ETHICS AND DISSEMINATION Results will be widely disseminated to various stakeholders to inform implementation and research efforts. Findings will also launch a Delphi method study leading to the development of an assessment tool for youth mental health services integration. This review does not require ethics approval.
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Affiliation(s)
- Cara A Settipani
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Maureen Rice
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Joanna L Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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12
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Stubbs B, Williams J, Shannon J, Gaughran F, Craig T. Peer support interventions seeking to improve physical health and lifestyle behaviours among people with serious mental illness: A systematic review. Int J Ment Health Nurs 2016; 25:484-495. [PMID: 27600483 DOI: 10.1111/inm.12256] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2016] [Indexed: 12/25/2022]
Abstract
People with serious mental illness (SMI) experience a premature mortality gap of between 10 and 20 years. Interest is growing in the potential for peer support interventions (PSI) to improve the physical health of people with SMI. We conducted a systematic review investigating if PSI can improve the physical health, lifestyle factors, and physical health appointment attendance among people with SMI. A systematic search of major electronic databases was conducted from inception until February 2016 for any article investigating PSI seeking to improve physical health, lifestyle, or physical health appointment attendance. From 1347 initial hits, seven articles were eligible, including three pilot randomized, control trials (interventions: n = 85, controls: n = 81), and four pretest and post-test studies (n = 54). There was considerable heterogeneity in the type of PSI, and the role of the peer support workers (PSW) varied considerably. Three studies found that PSI resulted in insignificant reductions in weight. Evidence from three studies considering the impact of PSI on lifestyle changes was equivocal, with only one study demonstrating that PSI improved self-report physical activity and diet. Evidence regarding physical health appointment attendance was also unclear across four studies. In conclusion, there is inconsistent evidence to support the use of PSW to improve the physical health and promote lifestyle change among people with SMI. The small sample sizes, heterogeneity of interventions, outcome measures, and lack of clarity about the unique contribution of PSW means no definitive conclusions can be made about the benefits of PSW and physical health in SMI.
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Affiliation(s)
- Brendon Stubbs
- Department of Physiotherapy, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Health Service and Population Research, King's College London, London, UK.,National Psychosis Service, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Julie Williams
- Department of Health Service and Population Research, King's College London, London, UK.,National Psychosis Service, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Jennifer Shannon
- Department of Health Service and Population Research, King's College London, London, UK
| | - Fiona Gaughran
- Department of Health Service and Population Research, King's College London, London, UK.,The Collaboration for Leadership in Applied Health Research and Care, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Tom Craig
- Department of Health Service and Population Research, King's College London, London, UK.,National Psychosis Service, South London and Maudsley National Health Service Foundation Trust, London, UK
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13
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Metse AP, Wiggers JH, Wye PM, Wolfenden L, Prochaska JJ, Stockings EA, Williams JM, Ansell K, Fehily C, Bowman JA. Smoking and Mental Illness: A Bibliometric Analysis of Research Output Over Time. Nicotine Tob Res 2016; 19:24-31. [PMID: 27980040 DOI: 10.1093/ntr/ntw249] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 09/29/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The prevalence of smoking among persons with a mental illness has remained unchanged, being 2-3 times higher than the general population in high-income countries. Assessment of the volume and characteristics of research output over time can assist in identifying research priorities to promote progress within a field. The aim of this study was to undertake such an assessment in the field of smoking and mental illness. METHODS A descriptive repeat cross-sectional study was conducted of peer-reviewed publications in Medline and PsycINFO for the periods 1993-1995, 2003-2005, and 2013-2015. Publications were classified as data- or non-data-based; data-based publications were further categorized by study type, population, setting, and for intervention-focused publications by level of evidence and research translation phase. RESULTS Included were 547 articles published in 1993-1995 (n = 65), 2003-2005 (n = 153), and 2013-2015 (n = 329). The number and proportion of data-based publications significantly increased over time, although their focus remained predominantly descriptive (≥83%); less than 14% of publications in any period had an intervention focus. The proportion of publications reporting on study populations with multiple diagnostic categories and recruiting from nonmental health settings, significantly increased from 1993-1995 to 2003-2005, however then plateaued by 2013-2015. The level of evidence provided by intervention-focused publications was suggested to increase over time, however there was no evident variation in translation phase. CONCLUSIONS Research has increased over time to characterize smoking among those with a mental illness; however more is needed to inform the development and implementation of effective cessation interventions for this group. IMPLICATIONS This is the first study to examine the volume and characteristics of research publications in the field of smoking and mental illness over time. The number of publications increased fivefold between 1993-1995 and 2013-2015. Between 1993-1995 and 2003-2005, progression was also indicated by increased: data-based publications, diagnostic diversity of samples, and variation in study settings; however further increases in such measures were not evident in 2013-2015. Notably, it continues to be the case that few intervention studies are undertaken. To achieve meaningful changes in the smoking prevalence of this group, a greater focus on research that assesses the effectiveness and implementation of tailored cessation interventions is required.
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Affiliation(s)
- Alexandra P Metse
- School of Psychology, University of Newcastle, Callaghan, Australia; .,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - John H Wiggers
- Hunter Medical Research Institute, New Lambton Heights, Australia.,Hunter New England Population Health, Wallsend, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Paula M Wye
- School of Psychology, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,Hunter New England Population Health, Wallsend, Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, New Lambton Heights, Australia.,Hunter New England Population Health, Wallsend, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
| | - Emily A Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - Jill M Williams
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Kerryn Ansell
- School of Psychology, University of Newcastle, Callaghan, Australia
| | - Caitlin Fehily
- School of Psychology, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jenny A Bowman
- School of Psychology, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
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14
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Heslop B, Wynaden D, Tohotoa J, Heslop K. Mental health nurses' contributions to community mental health care: An Australian study. Int J Ment Health Nurs 2016; 25:426-33. [PMID: 27084047 DOI: 10.1111/inm.12225] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/20/2016] [Accepted: 02/07/2016] [Indexed: 11/26/2022]
Abstract
Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses' experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.
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Affiliation(s)
- Brett Heslop
- Older Adult Sub Acute., Peel and Rockingham Kwinana Mental Health Service, Rockingham, Australia
| | - Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia.
| | - Jenny Tohotoa
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Karen Heslop
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
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15
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Plummer JT, Gordon AJ, Levitt P. The Genetic Intersection of Neurodevelopmental Disorders and Shared Medical Comorbidities - Relations that Translate from Bench to Bedside. Front Psychiatry 2016; 7:142. [PMID: 27597832 PMCID: PMC4992686 DOI: 10.3389/fpsyt.2016.00142] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/02/2016] [Indexed: 01/05/2023] Open
Abstract
Most psychiatric disorders are considered neurodevelopmental, and the associated genes often are expressed in tissues outside of the brain. This suggests a biological relatedness with medical co-occurrences that could have broad clinical implications for diagnosis and patient management over a lifetime. A qualitative integration of public data from genetic consortia of psychiatric disorders and medical comorbidities explores the question of whether genetically associated psychiatric illnesses present with co-occurring disturbances can be used to define specific mental-physical health relations. Novel patterns of gene-disorder relations appear with approximately one-third of conservatively defined, consortia-generated candidate risk genes with multiple psychiatric diagnoses. Moreover, nearly as many genes overlap with non-psychiatric phenotypes, including cardiovascular, renal, respiratory, and metabolic disturbances. While the landscape of genetic risk will change as study populations are expanded and biological confirmations accrue, the current relationships suggest that a mostly siloed perspective of gene relatedness to one categorical psychiatric diagnosis is not clinically useful. The future holds the promise that once candidates are fully validated, genome screening and mutation identification will bring more precision for predicting the risk for complex health conditions. Our view is that as genetic data are refined, continuing to decipher a shared pattern of genetic risk for brain and peripheral organ pathophysiology is not simply an academic exercise. Rather, determining relatedness will impact predictions of multifaceted health risks, patient treatment, and management.
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Affiliation(s)
- Jasmine T Plummer
- Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles , Los Angeles, CA , USA
| | - Alexis J Gordon
- Keck School of Medicine, University of Southern California , Los Angeles, CA , USA
| | - Pat Levitt
- Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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