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Curtis J, Teasdale SB, Morell R, Wadhwa P, Watkins A, Lederman O, O'Donnell C, Fibbins H, Ward PB. Implementation of a lifestyle and life-skills intervention to prevent weight-gain and cardiometabolic abnormalities in young people with first-episode psychosis as part of routine care: The Keeping the Body in Mind program. Early Interv Psychiatry 2024. [PMID: 38334187 DOI: 10.1111/eip.13508] [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: 08/21/2023] [Revised: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES In 2013, a cluster-controlled pilot study found the 12-week Keeping the Body in Mind (KBIM) lifestyle and life skills intervention was able to prevent weight gain in a small sample of youth experiencing first-episode psychosis (FEP) with fewer than 4 weeks of antipsychotic exposure. This study aims to evaluate the effectiveness of KBIM as routine care on anthropometry and metabolic biochemistry in a larger sample of youth with FEP across three community mental health services. METHOD This retrospective chart audit was conducted on youth with FEP, prescribed a therapeutic dose of antipsychotic medication, and who engaged with KBIM between 2015 and 2019. Primary outcomes were weight and waist circumference. Secondary outcomes were blood pressure, blood glucose, and blood lipids. Outcomes were collected in at baseline and at 12 weeks. Data on program engagement were obtained from the participant's medical file. RESULTS One-hundred and eighty-two people met inclusion criteria, and up to 134 people had baseline and 12-week data on one or more outcome. Mean number of sessions attended was 11.1 (SD = 7.3). Increases in weight and waist circumference were limited to 1.5 kg (SD = 5.3, t(133) = 3.2, p = .002) and 0.7 cm (SD = 5.8, t(109) = 1.2, p = .23) respectively. Eighty-one percent of participants did not experience clinically significant weight gain (>7% of baseline weight). There were no significant changes in blood pressure or metabolic biochemistry. CONCLUSION The prevention of substantial gains in weight and waist circumference observed in the initial pilot study was maintained with implementation of KBIM as part of routine clinical care for youth with FEP.
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Affiliation(s)
- Jackie Curtis
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
- Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Scott B Teasdale
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
- Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
| | - Rachel Morell
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
- Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
| | - Prarthna Wadhwa
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
- School of Health Sciences, UNSW Sydney, Kensington, New South Wales, Australia
| | | | - Hamish Fibbins
- Mindgardens Neuroscience Network, Sydney, New South Wales, Australia
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Philip B Ward
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
- Schizophrenia Research Unit, South Western Sydney Local Health District and Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia
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Watkins A, Stein-Parbury J, Curtis J, Poole J, Teasdale S, Fibbins H, Rossimel E, Lederman O, Ward PB, Rosenbaum S, Denney-Wilson E. Tackling change in mental health service delivery: A qualitative evaluation of a lifestyle program targeting mental health staff - Keeping our Staff in Mind (KoSiM). Health Promot J Austr 2023; 34:237-245. [PMID: 35718992 PMCID: PMC10083901 DOI: 10.1002/hpja.633] [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] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 01/30/2023] Open
Abstract
ISSUES ADDRESSED People with severe mental illness have adverse health outcomes compared to the general population. Lifestyle interventions are effective in improving health outcomes in this population. Current cultural processes in mental health services do not generally incorporate physical health care practices. Innovative education is required to improve knowledge and confidence of staff in the delivery of preventative health measures. METHODS The Keeping our Staff in Mind (KoSiM) program delivered a brief lifestyle intervention to mental health staff. A qualitative analysis following the Standards for Reporting Qualitative Research was undertaken. Semi-structured interviews designed to elicit information about the acceptability of the program and the impact of the intervention on participants' personal and professional lives. The interviews were analysed using thematic analysis, with coding independently developed and reviewed by three authors. RESULTS Of the 103 eligible participants, 75 were interviewed. Responses revealed four main themes: (i) positive changes in clinician's approach to physical health care, (ii) improvements in attitudes to self-care and family wellbeing, (iii) positive changes in workplace culture associated with physical health care delivery and (iv) high levels of acceptability of the program. CONCLUSION The KoSiM model may be useful in other settings as a means of changing the culture of mental health services to better integrate physical health care as a core part of mental health service provision. SO WHAT?: A novel approach using staff focussed lifestyle interventions model may cut through the resistance that is encountered when implementing proven methods of clinical intervention where cultural barriers exist.
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Affiliation(s)
- Andrew Watkins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josephine Poole
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Scott Teasdale
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Hamish Fibbins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Elisa Rossimel
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Oscar Lederman
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Curtis J, Teasdale S, Morell R, Wadhwa P, Lederman O, Fibbins H, Watkins A, Ward P. Implementation of a lifestyle and life-skills intervention to prevent weight-gain and cardiometabolic abnormalities in people with first-episode psychosis: the Keeping the Body in Mind program. Eur Psychiatry 2022. [PMCID: PMC9567044 DOI: 10.1192/j.eurpsy.2022.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction The development of obesity and metabolic abnormalities that seed future ill-health occur early with antipsychotic treatment. In 2013, the 12-week Keeping the Body in Mind (KBIM) pilot lifestyle intervention was delivered to a small sample of youth experiencing first-episode psychosis (FEP) with <4 weeks of antipsychotic exposure in a cluster-controlled design. The control group experienced significant increases in weight (mean 7.8kg) and waist circumference (mean 7.1cm) compared to non-significant increases (mean 1.8kg) in the KBIM group. Objectives To evaluate the effect of KBIM as routine care on anthropometry and metabolic biochemistry in a larger sample of youth with FEP across three mental health services. Methods This retrospective chart audit was conducted on youth with FEP, prescribed a therapeutic dose of antipsychotic medication, and who engaged with KBIM between 2015 and 2019. Primary outcomes were weight and waist circumference. Secondary outcomes were blood pressure, blood glucose and blood lipids. Outcomes were collected in a pre-post design. Implementation elements were also obtained from the participant’s medical file. Results One-hundred and eighty-two people met inclusion criteria. Follow-up data were available on up to 134 people for individual outcomes. Mean number of sessions attended was 11.1 (SD=7.3). Weight and waist changes were limited to 1.5kg (SD=5.3, t(133)=3.2, p=0.002) and 0.7cm (SD=5.8, t(109)=1.2, p=0.23). Nineteen percent experienced clinically significant weight gain. There were no changes to blood pressure or metabolic biochemistry. Conclusions The positive outcomes for weight and waist circumference found in the initial pilot study were maintained with implementation as routine care. Disclosure No significant relationships.
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Fibbins H, Edwards L, Morell R, Lederman O, Ward P, Curtis J. Implementing an Exercise Physiology Clinic for Consumers Within a Community Mental Health Service: A Real-World Evaluation. Front Psychiatry 2021; 12:791125. [PMID: 34899443 PMCID: PMC8651871 DOI: 10.3389/fpsyt.2021.791125] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Physical activity significantly improves mental illness symptoms and physical health for people living with mental illness. Mental health services do not routinely provide their consumers with access to exercise professionals for physical activity engagement. Barriers exist to integrating physical activity as part of standard care including staff culture, finance, and resources. This study examines the feasibility of newly established exercise physiology clinic within a mental health service in Sydney, Australia. Methods: A single site, open trial was conducted in a community centre within a large mental health district. A meeting room was converted into a part-time exercise physiology clinic where individualised physical activity interventions were delivered by an accredited exercise physiologist. Outcome measures including BMI, cardiovascular fitness, and self-reported physical activity were collected. Results: A total of 84 mental health consumers (17% of eligible consumers within the mental health service) participated in the clinic on average for one exercise session weekly. Moderate-to-vigorous physical activity significantly increased and sedentary time significantly decreased (p < 0.001). Conclusions: Exercise physiology clinics are feasible within mental health services and should be incorporated as part of standard care.
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Affiliation(s)
- Hamish Fibbins
- Keeping the Body in Mind, Sydney, NSW, Australia
- School of Psychiatry, UNSW Sydney, Randwick, NSW, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
| | - Law Edwards
- Keeping the Body in Mind, Sydney, NSW, Australia
| | - Rachel Morell
- Keeping the Body in Mind, Sydney, NSW, Australia
- School of Psychiatry, UNSW Sydney, Randwick, NSW, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
| | | | - Philip Ward
- School of Psychiatry, UNSW Sydney, Randwick, NSW, Australia
- Schizophrenia Research Unit, Liverpool Hospital, Ingham Institute of Applied Medical Research, Sydney, NSW, Australia
| | - Jackie Curtis
- Keeping the Body in Mind, Sydney, NSW, Australia
- School of Psychiatry, UNSW Sydney, Randwick, NSW, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
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Lederman O, Cashin AG, Fibbins H, Gaston J, Rosenbaum S, Stanton R. Burnout and compassion fatigue among Exercise Physiologists in mental healthcare. Occup Med (Lond) 2020; 70:633-640. [PMID: 33135069 DOI: 10.1093/occmed/kqaa177] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Burnout and compassion fatigue (CF) are common among mental health practitioners. Accredited Exercise Physiologists (AEPs) provide clinical services to individuals experiencing mental illness, increasing their likelihood of experiencing burnout and CF. AIMS To examine the prevalence of burnout and CF among AEPs working with people experiencing mental illness. METHODS An anonymous online cross-sectional survey of AEPs working with people experiencing mental illness was distributed via the Exercise and Sports Science Australia Mental Health Special Interest Group Facebook page between July and November 2019. In addition to demographics and caseload data, respondents completed the Professional Quality of Life scale and Oldenburg Burnout Inventory (OLBI). Results are reported using descriptive statistics. RESULTS Sixty-two AEPs (68%, n = 42 female) completed the survey. Most (n = 53, 86%) reported delivering services to consumers with severe mental health conditions. Less than half (n = 27, 44%) reported working in a dedicated mental health facility. Moderate levels of burnout and CF were experienced by 60% and 30% of respondents, respectively. CONCLUSIONS The prevalence of moderate burnout and CF symptoms in AEPs is comparable with other mental health professionals. Strategies to preserve psychological well-being such as enhancing mental health training for undergraduates and formalized supervision structures discussed.
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Affiliation(s)
- O Lederman
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - A G Cashin
- Neuroscience Research Australia, Sydney, Australia.,Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
| | - H Fibbins
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - J Gaston
- Centre for Emotional Health, Department of Psychology, Macquarie University, NSW, Australia
| | - S Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - R Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia.,Cluster for Resilience and Wellbeing, Appleton Institute, Central Queensland University, Adelaide, Australia
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Fibbins H, Ward PB, Curtis J, Watkins A, Lederman O, Morell R, Rosenbaum S. Effectiveness of a brief lifestyle intervention targeting mental health staff: analysis of physical fitness and activity in the Keeping Our Staff in Mind study. BMJ Open Sport Exerc Med 2020; 6:e000761. [PMID: 32685186 PMCID: PMC7359059 DOI: 10.1136/bmjsem-2020-000761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND People with mental illness die on average 15 years less than the general population, primarily to cardiometabolic disease. Lifestyle interventions are effective in reducing cardiometabolic risk but are not routinely provided to mental health consumers. Lifestyle interventions targeting mental health staff may be beneficial in changing culture surrounding physical health and subsequently improving consumer outcomes. This study examines exercise and fitness outcomes of a targeted lifestyle intervention directed at Australian mental health staff. METHODS A pragmatic single-arm intervention study was conducted within an Australian public mental health service. Mental health staff were provided a five-session individualised lifestyle intervention (incorporating exercise and nutritional counselling) over 5 weeks. Two waves of the programme were delivered between 2015 and 2016. This paper examines the exercise and fitness outcomes of the second wave of the study. Participants were assessed at baseline and at a 16-week follow-up. The primary exercise outcome was a measurement of cardiorespiratory fitness. Secondary outcomes included self-reported physical activity and a measurement of handgrip strength. RESULTS A total of 106 staff participated in this component of the study. Cardiorespiratory fitness increased significantly from baseline to follow-up (p<0.001). Significant improvements to physical activity occurred with decreases in sedentary time (p<0.0005) and increases in moderate-to-vigorous physical activity (p<0.005). CONCLUSION Lifestyle interventions incorporating exercise counselling may improve the physical health of mental health staff. Such strategies may be effective in improving culture surrounding physical health and/or increasing the effectiveness of lifestyle interventions targeting mental health consumers.
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Affiliation(s)
- Hamish Fibbins
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Schizophrenia Research Unit, Liverpool Hospital and Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
| | - Jackie Curtis
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Watkins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
- School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Rachel Morell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Black Dog Institute, Randwick, New South Wales, Australia
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Rossimel E, Teasdale SB, Poole J, Fibbins H, Curtis J, Watkins A, Rosenbaum S, Ward PB. Keeping our staff in mind: Dietary results of a lifestyle intervention targeting mental health staff. Health Promot J Austr 2020; 32:451-457. [PMID: 32589312 DOI: 10.1002/hpja.377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/22/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUES ADDRESSED 1) Describe the dietary intake of mental health staff within South Eastern Sydney Local Health District and 2) Evaluate the impact of an individualised staff lifestyle program on the following nutrition parameters; (i) energy, (ii) core food groups and (iii) discretionary foods. METHODS This was a pragmatic single-arm intervention study, conducted for all staff working in a public mental health service, in Sydney, Australia. A five-session individualised lifestyle intervention delivered over 5 weeks incorporated nutritional counselling delivered by a dietitian. Participants were assessed at baseline, following the intervention, and at follow-up using diet history to assess dietary intake. RESULTS Eighty-eight staff completed the dietary intervention and follow-up. An intake of core food groups significantly below national recommendations was reported for total vegetables (-1.75 ± 0.14 serves, P < .001), fruit (-0.29 ± 0.11 serves, P = .01), grains (-1.25 ± 0.20 serves, P < .001) and dairy servings (-1.00 ± 1.08 serves, P < .001), and protein-based foods were significantly above national recommendations (0.2 ± 0.09 serves, P = .03). At completion of the program, energy from discretionary foods was reduced by 460 kJ (95% CI -635 to -285, P < .001), and the serves of total vegetables (0.91 serves, 95% CI 0.59-1.22, P < .001) and dairy (0.31 serves, 95% CI 0.11-0.50, P < .001) were increased significantly. CONCLUSIONS A workplace-based well-being program for staff working in the mental health setting coincided with dietary improvements. SO WHAT Mental health staff can act as positive role models for clients to promote developing positive physical health behaviours.
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Affiliation(s)
- Elisa Rossimel
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - Scott B Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josephine Poole
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Andrew Watkins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Schizophrenia Research Unit, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Sydney, Australia
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Rosenbaum S, Ward PB, Baldeo R, Fibbins H, Jarman R, Lederman O, Perram A, Poole J, Rossimel E, Smith G, Teasdale S, Wade T, Watkins A, White A, Pearce D, Curtis J. Changing health workforce attitudes to promote improved physical health in mental health service users: Keeping our Staff in Mind (KoSiM). Health Promot J Austr 2020; 31:447-455. [PMID: 31925974 DOI: 10.1002/hpja.320] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 12/26/2022] Open
Abstract
ISSUE ADDRESSED People living with mental illness die on average 15 years earlier than the general population, primarily due to preventable and premature cardiovascular disease. Lifestyle interventions can be effective in reducing cardiovascular risk, yet mental health services do not routinely provide targeted lifestyle interventions. Exposing mental health staff to lifestyle interventions prior to targeting patients may be critical to changing culture and improving patient outcomes. This study aimed to improve the physical health of mental health staff through a targeted lifestyle intervention. METHODS A pragmatic single-arm intervention study was conducted in a public mental health service, including inpatient and community settings, in Sydney, Australia. Participants in this study were n = 212 clinical and non-clinical staff. A five-session individualised lifestyle intervention (delivered over 5 weeks) incorporating physical activity and nutritional counselling was delivered by multidisciplinary teams. Participants were assessed at baseline, following the intervention, and at follow-up (mean = 16.7 weeks). The primary outcome was the barriers, attitudes, knowledge and confidence regarding screening, promoting and intervening to improve physical health outcomes of patients (M-BACK questionnaire). Secondary outcomes included anthropometric measures, cardiorespiratory fitness, sedentary time and nutritional intake. Repeated measures ANCOVAs were performed. RESULTS A total of 212 staff (79% female) participated in this study. M-BACK total score significantly increased from baseline to follow-up (P < .001). Waist circumference, sedentary time and total energy intake all significantly decreased (all P's < .001) and cardiorespiratory fitness significantly increased (P < .001). CONCLUSION A brief lifestyle intervention for staff of a public mental health service may increase the capability of the participants to improve their own physical health. SO WHAT?: Improving staff health may be an important strategy in improving the uptake and/or the effectiveness of lifestyle interventions targeting mental health service users.
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Affiliation(s)
- Simon Rosenbaum
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, NSW, Australia.,Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Rishi Baldeo
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Rebecca Jarman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Amy Perram
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Josephine Poole
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Elisa Rossimel
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Gabriella Smith
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Tammy Wade
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Andrew Watkins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Annette White
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - David Pearce
- District Mental Health, South Eastern Sydney Local Health District, Kogarah, NSW, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia.,District Mental Health, South Eastern Sydney Local Health District, Kogarah, NSW, Australia
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Morell R, Curtis J, Watkins A, Poole J, Fibbins H, Rossimel E, Gerrard M, White A, Teasdale S, Ward PB, Lappin J. Cardio-metabolic risk in individuals prescribed long-acting injectable antipsychotic medication. Psychiatry Res 2019; 281:112606. [PMID: 31629301 DOI: 10.1016/j.psychres.2019.112606] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 07/22/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 12/24/2022]
Abstract
People living with severe mental illness (SMI) experience significant physical health co-morbidity. Few studies have focused on physical health outcomes for those prescribed long-acting injectable (LAI) antipsychotics. This observational cross-sectional study aimed to assess the prevalence of metabolic syndrome (MetS) and other cardio-metabolic risk factors in a large cohort prescribed LAI and managed by community mental health services. For participants with elevated cardio-metabolic risk factors, the proportion receiving appropriate management was assessed. Of the 301 eligible participants, many met the full criteria for MetS (44%) and its components. Cardio-metabolic risk factors were largely under- or un-treated. Smoking rates were very high (62%) along with reported high rates of physical inactivity and poor dietary intake. The vast majority (89%) reported seeing their general practitioner in the preceding twelve months. Individuals prescribed LAI have a very high prevalence of MetS and potentially modifiable risk factors for cardiovascular disease. Routine monitoring accompanied by evidence-based treatment of cardiometabolic abnormalities which contribute to significant morbidity, disability and premature death should be prioritised. Better collaboration between mental health services and primary care providers should be pursued to optimise the delivery of effective physical health care to individuals living with SMI.
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Affiliation(s)
- Rachel Morell
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia; School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia.
| | - Jackie Curtis
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia; School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Andrew Watkins
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia
| | - Josephine Poole
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia
| | - Hamish Fibbins
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia; School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Elisa Rossimel
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia
| | - Mark Gerrard
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia
| | - Annette White
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia
| | - Scott Teasdale
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia; School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Austraila
| | - Julia Lappin
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Bondi Junction, NSW, Australia; School of Psychiatry, UNSW Sydney, Kensington, NSW, Australia
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Fibbins H, Lederman O, Morell R, Furzer B, Wright K, Stanton R. Incorporating Exercise Professionals in Mental Health Settings: An Australian Perspective. ACTA ACUST UNITED AC 2019. [DOI: 10.31189/2165-6193-8.1.21] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ABSTRACT
Low rates of physical activity, in addition to other poor physical health behaviors, contribute to lower quality of life and increased rates of premature mortality for people living with mental illness. Physical activity reduces this mortality gap while simultaneously improving mood, cognitive function, and symptomology for a variety of psychiatric disorders. While physical activity programs are feasible and acceptable in this population, significant barriers exist that limit long-term adherence. Accredited exercise physiologists (AEPs) are best-placed in Australia to lead physical activity interventions for people living with mental illness. Additionally, AEPs provide an important role in improving culture change within mental health settings by influencing clinicians' attitudes to physical activity interventions. Leading international mental health organizations should collaborate and promote the role of physical activity to increase the provision of such services to people living with mental illness.
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Fibbins H, Czosnek L, Stanton R, Davison K, Lederman O, Morell R, Ward P, Rosenbaum S. Self-reported physical activity levels of the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference delegates and their exercise referral practices. J Ment Health 2018; 29:565-572. [PMID: 30322334 DOI: 10.1080/09638237.2018.1521935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Physical activity (PA) significantly improves physical health and clinical symptoms across mental disorders. Accredited Exercise Physiologists (AEPs) are trained to lead PA interventions for people with mental illness, but referrals to AEPs are low.Aims: To determine the knowledge and attitudes of delegates attending the 2017 Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference toward physical health monitoring and exercise interventions for people with mental illness.Methods: A cross-sectional survey of RANZCP delegates investigated knowledge and attitudes toward PA for people with mental illness, self-reported PA, and their understanding of AEP's role within mental health settings. A subgroup of delegates underwent fitness assessments.Results: Seventy-three delegates completed surveys and 24 underwent fitness assessments. Delegates demonstrated good knowledge regarding associations between PA and cardiovascular disease risk. Delegates were less knowledgeable of AEP's role within mental health settings. Forty-six participants (63%) did not meet the Australian recommended guidelines for PA. No association between referrals to AEPs and self-reported PA or fitness measures were evident.Conclusions: Promoting PA participation for mental health professionals, coupled with education on the important role AEPs play in the multidisciplinary treatment of mental health consumers is vital to improve health outcomes for this vulnerable group.
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Affiliation(s)
- Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Australia
| | - Louise Czosnek
- Exercise and Sports Science Australia, Brisbane, Australia.,Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kade Davison
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Medical Science, UNSW Sydney, Sydney, Australia
| | - Rachel Morell
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Australia
| | - Philip Ward
- School of Psychiatry, UNSW Sydney, Australia.,Schizophrenia Research Unit, Liverpool Hospital and Ingham Institute of Applied Medical Research, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Australia.,The Black Dog Institute, Prince of Wales Hospital, Randwick, Australia
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Fibbins H, Ward PB, Watkins A, Curtis J, Rosenbaum S. Improving the health of mental health staff through exercise interventions: a systematic review. J Ment Health 2018; 27:184-191. [PMID: 29447044 DOI: 10.1080/09638237.2018.1437614] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. AIMS We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. METHOD A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. RESULTS Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. CONCLUSIONS Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.
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Affiliation(s)
- Hamish Fibbins
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia
| | - Philip B Ward
- b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia.,c Schizophrenia Research Unit , South Western Sydney Local Health District , Sydney , NSW , Australia.,d Ingham Institute for Applied Medical Research , Liverpool , NSW , Australia
| | - Andrew Watkins
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,e Faculty of Health, University of Technology , Sydney , NSW , Australia , and
| | - Jackie Curtis
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia
| | - Simon Rosenbaum
- b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia.,f The Black Dog Institute , Randwick , NSW , Australia
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