Investigating change in non-government mental health service organisations’ ‘smoke-free’ attitudes and practice in New Zealand

Abstract

Smoking prevalence amongst service users from the mental health and addictions sectors is higher than the general population. Cross-sectional web- or paper-based surveys comprising open and closed response options were used to examine changes in prevailing attitudes and practices amongst non-government mental health service staff and users. Thematic analysis was used to interpret and present open response answers. Multi-variate logistic models were used to investigate which factors are associated with smoke-free attitudes and practices. Staff who smoke were found to be less likely to provide cessation support to clients (AOR 0.51, 95% CI 0.31–0.82) and gave significantly lower estimates of the percentage of clients who wish to stop smoking (30% vs 44%, p < 0.0001). Those who had completed cessation training also had more positive views about the importance of providing cessation support and service user desire to stop smoking. Staff who had not completed cessation training had significantly lower odds of reporting they carried out quit smoking support often and routinely (AOR 0.33, 95% CI 0.23–0.47) The results suggest that continuing improvement will be enabled by increasing rates of cessation training amongst staff of mental health and addictions non-government organisations. In addition, there is a need for increased incentive and support for staff who smoke to quit.

Exploring Support Provided by Community Managed Organisations to Address Health Risk Behaviours Associated with Chronic Disease among People with Mental Health Conditions: A Qualitative Study with Organisational Leaders

“…Further, findings from our current study, as well as past evidence [7,16,17], support the importance of factors such as staff training and education and positive workplace culture in facilitating the provision of preventive care for health risk behaviours. However, in practice, it is unclear whether policies to promote workplace culture or staff education and training are routinely and systematically embedded in CMOs.…”

“…Research exploring care provision addressing health risk behaviours within CMOs for consumers with mental health conditions has been limited by: (1) focusing on physical health broadly (i.e., encompassing all health from minor ailments through to chronic diseases such as cancer, with no specific focus on health risk behaviours) ( [12][13][14][15]); (2) focusing on one health risk behaviour only [16,17]; (3) combining results for CMO-delivered and public mental health services [18][19][20][21]; and (4) combining results for populations of individuals with and without mental health conditions [22,23]. Outside of Australia, no research to the authors knowledge has explored the care being provided by CMOs to address multiple health risk behaviours among consumers with mental health conditions.…”

Barriers to the Provision of Preventive Care to People Living with Mental Health Conditions: Self-Report by Staff Working in an Australian Community Managed Organisation

“…Internationally, few studies have explored barriers to CMOs addressing health risk behaviours among people with mental health conditions [37,38]. One qualitative study of leaders of US psychiatric rehabilitation services ( [38] comparable to CMOs in Australia) identified barriers to providing physical health support to include difficulties coordinating with external providers, using health IT, and finding staff who were competent and enthusiastic about providing physical health support to consumers.…”

“…However, this study did not comprehensively assess possible barriers and interviewed leaders of organisations rather than staff providing direct support to consumers. Only one study internationally has assessed CMO staff perceptions of facilitators or barriers to preventive care provision for a health risk behaviour [37]. This study focused on tobacco smoking and was conducted among 605 staff working across multiple CMOs in New Zealand.…”