Background: Adults with a serious mental illness (SMI) are at greater risk of physical health morbidity and premature death than the general population, largely as a result of preventable physical health issues. Staff working in mental health services have a role to play in addressing these inequalities, but little is known about how they perceive their role and how this impacts on their practice. Understanding this better would enable services to improve their approach and support better health outcomes for SMI patients. A service evaluation was undertaken to investigate how physical healthcare is approached within adult community mental health teams (CMHTs) at a South London (UK) Mental Health Trust. Methods: This was a prospective, cross-sectional evaluation design. Interviews and focus groups were conducted with clinical staff, service users and carers, to understand their experiences and to identify key barriers and facilitators to supporting physical healthcare support for adults with SMI. Thematic analysis was conducted to identify key themes which were classified into five main categories. Results: 50 participants took part in the study, 38 were clinical staff, eight were service users and four were carers. We found staff widely recognised the importance of supporting physical healthcare. However, there was variability in how staff approached physical healthcare in routine practice, and differences in how physical healthcare is experienced by service users and carers. Staff were keen to engage in changes to the way physical healthcare is delivered in CMHTs. However, they sought clearer guidance on their roles and responsibilities, and wanted to better understand the rationale for changes in community mental health practice, such as increased screening for physical healthcare. Service users and carers felt equally that the role of CMHTs in physical healthcare was unclear, which limited their ability to access it and understand the benefit for their overall care. Staff articulated gaps in leadership and training that impacted on their ability to implement the overall vision for physical healthcare within the Trust. Conclusion: Mental health staff recognise the role they play in supporting the physical health of adults living with SMI. This evaluation provides insight into common barriers and facilitators faced by staff, service users and carers when providing or accessing physical healthcare within adult CMHTs. These findings indicate a more comprehensive and better articulated approach to physical healthcare in mental health Trusts is needed to ensure service users and their carers understand what support is available and how to access it and to equip staff to provide and sustain that care in routine practice.

BackgroundAdults with a serious mental illness (SMI) are at greater risk of physical health morbidity and premature death than the general population, largely as a result of preventable physical health issues. Staff working in mental health services have a role to play in addressing these inequalities, but little is known about how they perceive their role and how this impacts on their practice. Understanding this better would enable services to improve their approach and support better health outcomes for SMI patients. A service evaluation was undertaken to investigate how physical healthcare is approached within adult community mental health teams (CMHTs) at a South London (UK) Mental Health Trust.MethodsThis was a prospective, cross-sectional evaluation design. Interviews and focus groups were conducted with clinical staff, service users and carers (non-professional caregivers e.g., family or friends, of adults living with an SMI), to understand their experiences and to identify key barriers and facilitators to supporting physical healthcare support for adults with SMI. Thematic analysis was conducted to identify key themes which were classified into five main categories.Results50 participants took part in the study, 38 were clinical staff, eight were service users and four were carers. We found staff widely recognised the importance of supporting physical healthcare. However, there was variability in how staff approached physical healthcare in routine practice, and differences in how physical healthcare is experienced by service users and carers. Staff were keen to engage in changes to the way physical healthcare is delivered in CMHTs. However, they sought clearer guidance on their roles and responsibilities, and wanted to better understand the rationale for changes in community mental health practice, such as increased screening for physical healthcare. Service users and carers felt equally that the role of CMHTs in physical healthcare was unclear, which limited their ability to access it and understand the benefit for their overall care. Staff articulated gaps in leadership and training that impacted on their ability to implement the overall vision for physical healthcare within the Trust.ConclusionMental health staff recognise the role they play in supporting the physical health of adults living with SMI. This evaluation provides insight into common barriers and facilitators faced by staff, service users and carers when providing or accessing physical healthcare within adult CMHTs. These findings indicate a more comprehensive and better articulated approach to physical healthcare in mental health Trusts is needed to ensure service users and their carers understand what support is available and how to access it and to equip staff to provide and sustain that care in routine practice.

BACKGROUND People with severe mental illness (SMI) are more likely to suffer from physical health conditions than the general population, with a lower life expectancy of up to 18 years. Little is known about the experience of people with SMI using digital health interventions (DHIs) to support their physical health, and whether they perceive such interventions as beneficial. OBJECTIVE We explored how people with SMI use DHIs to support their physical health, the acceptability, factors effecting use and any perceived impact on physical health. METHODS A mixed methods approach was used, delivered in three stages. Stage 1 online survey of people with SMI; Stage 2 interviews with a sub-sample of participants from Stage 1; Stage 3 stakeholder workshops with people with SMI, clinical staff, carers, voluntary sector staff and commissioners. Study design, data collection and analyses were co-produced with two Experts by Experience with lived experience of SMI. RESULTS Stage 1 results revealed that participants were generally satisfied with the quality of DHIs available to them. The most popular DHIs were targeted at diet, exercise, and weight management. Stage 2 results suggested participants experienced a number of barriers and facilitators to use of DHIs. Factors that encouraged use included simplicity, passivity, and data-linkage. Concerns included costs, data security and reliability of information. Positive impacts included accountability, encouragement, and tangible physical health benefits. Self-awareness and autonomy of care were also perceived to increase. Mental health impacted engagement with DHIs: low mood often hindered motivation to engage with devices, and information produced by these devices could be perceived as triggering. Findings of stage 2 were corroborated in stage 3: workshop participants reported that DHIs could be a useful tool to monitor physical health but could not replace contact with clinical services. The two could be used in conjunction, to expand the benefit of clinical appointments and encourage service user autonomy. Participants appreciated being able to share physical health data in appointments and suggested that data sharing between service user and care team could be a positive feature. Participants sought clinical guidance and recommendations for which devices they could use to monitor or support their physical health. CONCLUSIONS Popular DHIs for supporting physical health were considered useful and acceptable by people with SMI and may be used as an extension of clinical care, giving people with SMI a sense of control and involvement in their own health. The specific needs and priorities of people with SMI should be considered both in developing and recommending interventions.