Cardiovascular Risk Assessment and Management in Mental Health Clients: Whose Role is it Anyway?

Wheeler, Amanda; Harrison, Jeff; Mohini, Priya; Nardan, Jeshika; Tsai, Amy; Tsai, Eve C.

doi:10.1007/s10597-009-9237-0

Cited by 30 publications

(56 citation statements)

References 36 publications

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“…These professional boundaries are integral to the culture of biomedicine, which separates physical from mental health care, and assigns certain goals, responsibilities, and procedures to each medical specialty, including concerns about liability and basic competence (Good, 1994). Consistent with our findings, professional boundaries can produce uncertainty among mental health clinicians regarding their role and responsibilities in helping consumers with SMI with their physical health issues (Kilbourne, Greenwald, Bauer, Charns, & Yano, 2012; Wheeler et al, 2010). …”

Section: Discussionsupporting

confidence: 87%

Contextual Factors in the Health of People With Serious Mental Illness

et al. 2014

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People living with serious mental illness (SMI) have shorter life expectancies than the general population. We examined how contextual factors influence the physical health of this population. We conducted interviews, focus groups, and participant observations with stakeholders from six behavioral health organizations. We found that consumers’ avoidance of overt disagreement during medical visits, their mistrust of medical institutions, and cultural variations in body image influenced the clinical encounter. Mental health providers’ ambivalence about intervening in consumers’ physical health, primary care providers’ misattribution of physical symptoms to mental disorders, and providers’ stigmatization of consumers shaped clinical encounters. Consumers’ diets were shaped by food environments and social norms associated with traditional diets. Internal and external factors impacted consumers’ physical activity. In this article, we illustrate the importance of considering contextual factors in the development and implementation of interventions aimed at improving the physical health of people with SMI.

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Section: Discussionsupporting

confidence: 87%

Contextual Factors in the Health of People With Serious Mental Illness

et al. 2014

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“…The findings of this large survey confirm what has been noted through qualitative studies (Happell, Scott, Platania-Phung et al, 2012;Wheeler et al, 2010) -nurse responses indicate that a positive healthcare environment, in terms of 290 B. HAPPELL AND C. PLATANIA-PHUNG collaboration of nurses and consumers on preventative care, may positively influence clinical practices. However, the results also indicate that perceived barriers to encouraging the lifestyle change of consumers with SMI may not necessarily influence health promotion by nurses, even if they have perceptions that there is preventative care taking place in general.…”

Section: Discussionsupporting

confidence: 80%

Cardiovascular Health Promotion and Consumers with Mental Illness in Australia

Happell

Platania‐Phung

2015

Issues in Mental Health Nursing

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People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.

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“…Furthermore, effectiveness of MM has not been described with randomised controlled trials at this time [12]. Therefore, clinicians are without a clear MM model and confusion among who is responsible for MM (i.e., primary or secondary care) persists [13,14]. …”

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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Cardiovascular Risk Assessment and Management in Mental Health Clients: Whose Role is it Anyway?

Cited by 30 publications

References 36 publications

Contextual Factors in the Health of People With Serious Mental Illness

Contextual Factors in the Health of People With Serious Mental Illness

Cardiovascular Health Promotion and Consumers with Mental Illness in Australia

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

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