Monitoring and management of metabolic abnormalities: mixed-method evaluation of a successful intervention

Abstract

Let's Get Physical is cost effective in enhancing adherence to monitoring guidelines. The use of clinical algorithms supporting timely response to abnormalities should be considered. Ongoing education, role clarity and dedicated resources are required if psychiatrists are to contribute meaningfully to improving the physical health of people with mental illness.

Attending to physical health in mental health services in Australia: a qualitative study of service users’ experiences and expectations

“…, Wilson et al . ), substantial investment has been made in efforts to improve services. Diverse interventions including development of service protocols (Tully et al .…”

“…), scheduling screening at service rather than individual level (Wilson et al . ) and introduction of new dedicated positions (Happell et al . ) have been trialled and evaluated.…”

Care coordinator views and experiences of physical health monitoring in clients with severe mental illness: A qualitative study

“…A key finding of our study was the facilitative influence of performance monitoring policies on care coordinators' recognition of clients' physical health needs. This motivational value of performance monitoring corresponds with past recommendations to improve the provision of physical healthcare through encouraging the accountability of staff via assessing adherence to physical health monitoring protocols (Wilson et al, 2014), and monitoring practitioners' performance regarding physical health interventions (Eldridge et al, 2011). The current UK clinical guidelines specify that routine monitoring of physical health indicators should be audited in annual team reports, and that healthcare trusts should ensure compliance with physical healthcare monitoring through utilising performance indicators (NICE, 2014).…”

“…Even when mental health staff have been overtly positioned to attend to clients' physical health, challenges were reported due to the perceived incongruence with what was considered a part of the culture of mental health services (Dunbar et al, 2010;Wilson et al, 2014). To improve physical health monitoring practices, previous literature has recommended role clarification and appointing specific members of mental health service staff as responsible for physical health monitoring (Dunbar et al, 2010;Happell et al, 2011; Working Group for Improving the Physical Health of People with SMI, 2016), and training regarding the importance of attending to physical health for mental health staff (Baxter et al, 2016;Happell et al, 2013;Wynaden et al, 2016).…”

“…This has been attributed to a range of factors (De Hert et al, 2011), including a lack of training, guidelines and general awareness of the importance of physical health monitoring (Happell, Platania-Phung, & Scott, 2013;Millar et al, 2014), concerns of increasing workloads (Dunbar, Brandt, Wheeler, & Harrison, 2010;Happell et al, 2011;Wilson, Randall, & Weaver, 2014), uncertainty amongst healthcare professionals regarding whose responsibility this task is (Barnes, Paton, Cavanagh, Hancock, & Taylor, 2007;Wilson et al, 2014), and staff attitudes regarding what falls within their clinical role (Chadwick & Withnell, 2016;Dunbar et al, 2010;Wilson et al, 2014). …”