Identifying Barriers to Improving the Wellness of Persons With Severe Mental Illness in Community Residential Mental Health Facilities

Shor, Ron; Msw, Anat Shalev

doi:10.1080/15332985.2013.779360

Cited by 12 publications

(27 citation statements)

References 15 publications

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“…In considering the poor rate of implementation of metabolic care activities, many health care system-related factors (e.g., lack of role clarity within treating teams regarding responsibility for screening, lack of continuity of care, limited time and resources for physical and medical examinations, separation of medical and mental health care systems) represent significant barriers to change [ 21 , 22 ]. Moreover, nurses working in mental health have reported personal barriers to monitoring, such as competing priorities and concerns regarding the outcomes of screening [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Use of an electronic metabolic monitoring form in a mental health service – a retrospective file audit

et al. 2016

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BackgroundPeople with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Routine metabolic monitoring is proposed as a method of identifying risk factors for metabolic abnormalities. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, however. This present study reports on the recent implementation of a routine metabolic monitoring form at a mental health service in regional Australia.MethodsA retrospective file audit was undertaken on 721 consumers with electronic health records at the mental health service. Descriptive statistics were used to report the frequency of use of the metabolic monitoring form and the range of metabolic parameters that had been recorded.ResultsConsumers had an average age of 41.4 years (SD = 14.6), over half were male (58.4 %), and the most common psychiatric diagnosis was schizophrenia (42.3 %). The metabolic monitoring forms of 36 % of consumers contained data. Measurements were most commonly recorded for weight (87.4 % of forms), height (85.4 %), blood pressure (83.5 %), and body mass index (73.6 %). Data were less frequently recorded for lipids (cholesterol, 56.3 %; low density lipoprotein, 48.7 %; high density lipoprotein, 51.7 %; triglycerides, 55.2 %), liver function (alanine aminotransferase, 66.3 %; aspartate aminotransferase, 65.5 %; gamma-glutamyl transpeptidase, 64.8 %), renal function (urea, 66.3 %; creatinine, 65.9 %), fasting blood glucose (60.2 %), and waist circumference (54.4 %).ConclusionsThe metabolic monitoring forms in consumer electronic health records are not utilised in a manner that maximises their potential. The extent of the missing data suggests that the metabolic health of most consumers may not have been adequately monitored. Addressing the possible reasons for the low completion rate has the potential to improve the provision of physical health care for people with mental illness.

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Section: Introductionmentioning

confidence: 99%

Use of an electronic metabolic monitoring form in a mental health service – a retrospective file audit

et al. 2016

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“…Such monitoring involves quantifying risk factors for cardiovascular diseases such as blood pressure, cholesterol, blood sugar levels, waist and hip circumference, and body mass and stature [ 6 , 7 ], along with modifiable lifestyle behaviours (e.g., tobacco smoking, alcohol consumption, physical activity, and nutrition) and antipsychotic medication prescription. However, selecting and implementing a MM model can be problematic due to perceptions of efficacy within services and staff [ 6 , 8 – 10 ]. Furthermore, pessimism persists about the effect of healthy lifestyle recommendations post MM on consumer behaviours [ 1 ] and health outcomes [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study

et al. 2014

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BackgroundPeople with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases.MethodsA retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 – August 2013).ResultsA total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options.ConclusionsThe results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.

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“…These findings echo views of mental health consumers and healthcare providers voiced via academic research (Hyland et al . , Shor & Shalev ) that the inadequate coordination does not allow an adequate quality of physical health care. It also is similar to findings of the views of informal carers of people with physical illnesses in that care coordination is a significant problem in health services (McPherson et al .…”

Section: Discussionmentioning

confidence: 99%

Filling the gaps and finding our way: family carers navigating the healthcare system to access physical health services for the people they care for

Happell

Wilson

Platania‐Phung

et al. 2017

Journal of Clinical Nursing

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Identifying Barriers to Improving the Wellness of Persons With Severe Mental Illness in Community Residential Mental Health Facilities

Cited by 12 publications

References 15 publications

Use of an electronic metabolic monitoring form in a mental health service – a retrospective file audit

Use of an electronic metabolic monitoring form in a mental health service – a retrospective file audit

The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study

Filling the gaps and finding our way: family carers navigating the healthcare system to access physical health services for the people they care for

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