Improving physical health outcomes for people with severe mental illness: A proof‐of‐concept study of nurse practitioner candidate practice

Consumers of mental health services experience poor physical health compared to the general population, leading to long‐term physical illness and premature death. Current research and policy activity prioritizes the physical health of consumers yet few of these recommendations have translated to practice. This implementation gap may be influenced by the paucity of literature exploring consumer perceptions and experiences with physical healthcare and treatment. As a result, little is understood about the views and attitudes of consumers towards interventions designed to improve their physical health. This integrative review aims to explore the literature regarding consumer perspectives of physical healthcare and, interventions to improve their physical health. A systematic search was undertaken using (i) CINAHL, (ii) MEDLINE, (iii) PsycINFO, (iv) Scopus, and (v) Google Scholar between September and December 2021. Sixty‐one papers comprising 3828 consumer participants met the inclusion criteria. This review found that consumers provide invaluable insights into the barriers and enablers of physical healthcare and interventions. When consumers are authentically involved in physical healthcare evaluation, constructive and relevant recommendations to improve physical healthcare services, policy, and future research directions are produced. Consumer evaluation is the cornerstone required to successfully implement tailored physical health services.

Section: Resultsmentioning

confidence: 99%

“…Physical health interventions delivered by mental health nurses have been reported by consumers as positive, helpful, and valuable (Furness et al . 2020; Hassan et al . 2020a, 2020b; Rönngren et al .…”

Section: Resultsmentioning

confidence: 99%

Mental health consumers' perspectives of physical health interventions: An integrative review

Tabvuma

Stanton

Browne

et al. 2022

“…2018; Furness et al . 2020). These studies have shown positive results in both increasing rates of CMM and providing clinical leadership within the settings, making CMM more visible to other staff (Brown et al .…”

Section: Discussionmentioning

confidence: 99%

Physical health assessment and cardiometabolic monitoring practices across three adult mental health inpatient units – a retrospective cohort study

Howard

Kühn

Millar

et al. 2020

Australians with lived experience of mental illness die on average 10 or more years earlier than the general population. Cardiometabolic disorders, including cardiovascular disease and diabetes mellitus, are common causes of premature death in this cohort. Little is known about cardiometabolic monitoring practices in mental health inpatient units. The aim of this study was to examine the characteristics of cardiometabolic monitoring and physical health assessments of adult mental health consumers within the first 72 hours of admission to an inpatient unit. We implemented a retrospective descriptive exploratory design by medical record audit. Data were collected using a pre‐validated audit tool, adapted with recent literature and policy, from a randomly selected sample of consumers admitted to three acute mental health adult inpatient units of a large Australian metropolitan health service in 2016. Of 228 consumers, the mean age was 37.5 (range 18–64) years and 51.3% were women. Cardiometabolic risks were common, yet most consumers received incomplete cardiometabolic monitoring. While few consumers (15%) were diagnosed with cardiometabolic comorbidities, 67.5% were prescribed psychotropic medications with high cardiometabolic risk. Compliance with recommended cardiometabolic monitoring varied considerably between risk factors: for example, blood pressure was measured in 56.1% of consumers, whereas waist circumference was never recorded. There were no statistically significant associations between cardiometabolic monitoring completion and sex or cardiometabolic risk. These findings demonstrate the need for increased education and awareness of cardiometabolic risk and identify a critical gap between physical health assessment practices and recommendations for this cohort.

“…2018) and community (Furness et al . 2020) teams, particularly with specialist roles such as physical health nurses and nurse practitioners to lead and strengthen physical health care. In addition to specialist physical healthcare roles in mental health settings, the findings of this study indicate a clear need to support consumers to attend specialist medical treatment for their physical health conditions.…”

Section: Relevance For Clinical Practicementioning

confidence: 99%

“…body mass index ≥30 kg/m 2 ) among consumers has been reported between 41% (Furness et al . 2020) to 59% (Annamalai et al . 2017) compared with the global population prevalence of 13% (World Health Organisation 2018c).…”

Section: Introductionmentioning

confidence: 99%

Natural cause mortality of mental health consumers: A 10‐year retrospective cohort study

Suggett

Foster

Lakra

et al. 2020

Self Cite

People with mental illness have substantially lower life expectancy than the general population, with mortality from natural causes most commonly attributed to cardiovascular diseases. The study aim was to identify characteristics of consumers who died of natural causes between 2009 and 2018 at one of Australia’s largest publicly funded mental health services. Data were collected with a retrospective medical record review of 102 consumers. Mean mortality age was 52.4 years (SD = 10.7) (with females 51.9 years [SD = 12.0], and males 52.7 years [SD = 9.9]), which was more than 30 years lower than the Australian population. Cardiovascular diseases were the most frequent mortality cause (39%), followed by respiratory conditions (23%), cancers (20%), and all other causes (19%). Sixty (61%) consumers had at least three co‐occurring physical health conditions. Seventy‐five (74%) smoked tobacco. Consumers who died from cardiovascular diseases were less likely to attend specialist medical follow‐up for their condition (P = 0.004), and more likely to die at home (P = 0.001). Consumers whose mortality age was above 55 years were more likely to have three co‐occurring physical health conditions (P = 0.034). Consumers whose mortality age was below 55 years were more likely to have sub‐optimal nutritional intake (P = 0.014) and higher body mass index (P = 0.008). There is a critical need to close the life expectancy gap for consumers. This requires dedicated focus on reducing mortality risk due to modifiable clinical characteristics which lead to consumer mortality. Mental health nurses play a key role in helping reduce consumers’ mortality and morbidity risk through prevention and early intervention strategies.