Family carers: A role in addressing chronic disease risk behaviours for people with a mental illness?

Abstract

People with a mental illness experience greater chronic disease morbidity and mortality compared to those without mental illness. Family carers have the potential to promote the health behaviours of those they care for however factors which may influence the extent to which they do so have not been reported. An exploratory study was conducted to investigate carers': 1) promotion of fruit and vegetable consumption, physical activity, quitting smoking, and reducing alcohol consumption; 2) perceptions of their role and ability to promote such behaviours; 3) and the association between carer perceptions and the promotion of such behaviours. A cross-sectional survey was conducted with mental health carers (N = 144, 37.6% response rate) in New South Wales, Australia in 2013. Associations between current promotion of health behaviours and carer perceptions were explored through multivariate regression analysis in 2016. A majority of respondents promoted fruit and vegetable consumption (63.8%), physical activity (60.3%), quitting smoking (56.3%), and reducing alcohol consumption (56.2%) to the person they cared for. A perception that it was ‘very important’ to have a positive influence on these behaviours was positively related with promotion of each of the four behaviours, with those holding such a view being more likely to promote such behaviours, than those who did not (odds ratio: 9.47–24.13, p < 0.001). The majority (56.2%–63.8%) of carers reported promoting the health behaviours of those they cared for, demonstrating a need and opportunity to build the capacity of carers to contribute to reducing the health risk behaviours among people with a mental illness.

Providing physical health care for people accessing mental health services: Clinicians’ perceptions of their role

“…Carers are another potentially valuable resource in supporting consumers' physical health. This avenue is being explored and evaluated as are carers' own needs in this endeavour (Aschbrenner et al 2014;Bailey et al 2017;Happell et al 2017). The use of signage, particularly digital signage in waiting rooms and staff areas, may also assist in re-enforcing specific health messages and could be employed in a similar fashion with clinicians to promote the uptake of evidence-based practices.…”

Supporting change in chronic disease risk behaviours for people with a mental illness: a qualitative study of the experiences of family carers

“…Additionally, a descriptive correlational study of 27 family carers supporting an adult with schizophrenia and diabetes mellitus from the United States reported 89% of carers prepared meals for their family member with 78% preventing high-fat, high-sugar food intake; 22% encouraged their family member to stop drinking alcohol; and 59% assisted their family member with exercise [ 48 ]. Finally, a quantitative Australian study of 144 family carers of adults with a mental illness reported the majority of carers tried all or most of the time to positively influence: fruit and vegetable consumption (63.8%), physical activity (60.3%), smoking (56.3%), and alcohol consumption (56.2%) [ 49 ].…”

“…Three of the identified studies were also the only previous research that reported potential barriers to carers addressing the chronic disease risk behaviours of the person they care for, and possible strategies for overcoming them [ 41 , 46 , 49 ]. The qualitative study conducted in Australia found a dissonance between carer concerns for the negative health effects of smoking and the autonomy of their family member, with some carers reporting facilitating access to cigarettes rather than supporting cessation attempts [ 46 ].…”

Preventive care for physical activity and fruit and vegetable consumption: a survey of family carer expectations of health service delivery for people with a mental health condition

“…Such findings may suggest carers' own risk status may not impact on their perceptions of physical health care for their family members with a mental health condition. Further research is required to explore this finding to determine if carers may have the potential to support health risk behaviour change among people with a mental health condition (which a limited body of research suggests [78,79,101,102,107,108]) and if their own risk status may impact on such a potential. Research among mental health professionals suggests the provision of support to change health risk behaviours may be decreased in those professionals engage in health risk behaviours [66].…”