Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey

Abstract

Background This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). Methods An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. Results A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001). Conclusion The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.

Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children

“…The stories shared by parents in this study are unique in that they provide narrative to parental perception and awareness of the potential ramifications of poor oral health on child mental wellbeing, particularly confidence and self-esteem, which often stemmed from personal experiences. Due to the recognised link between oral health and mental health, researchers and organisations in Australia have begun exploring an integrated approach to oral health and mental health [ 72 , 73 , 74 ]. One social worker in Western Australia highlighted the visible difference she observes in her clients, “ When people do actually get oral health managed and seen the difference that it makes is phenomenal… People are smiling.…”

Initiatives to improve physical health for people in community-based mental health programs

“…38 Intervention length ranged from six weeks 45 to 12 months 33,34,37 , with the number of sessions ranging from 6 45 to 50. 33,37 The duration of intervention was unclear for six studies 31,36,43,[56][57][58] , and the number of sessions was unclear for seven studies. 31,33,36,39,41,43,44 All interventions consisted of multiple strategies with the exception of two that solely used assistance, practical support and demonstrations.…”

“…Of the eight identified studies, three were higher evidence level studies (RCTs 60,62,63 ), and five were lower evidence level studies (pre-post evaluations [56][57][58]61,65 ). One of these studies was described as a cluster-RCT 56 , however, it compared two different models with no comparison group, and as such is treated as a lower evidence level study (pre-post).…”

“…61,63 The eighth study reported an initiative to improve staff provision of oral health care, with no clear indication of the specific model, content or support that providers were encouraged to provide to consumers. 57 Across all eight studies, the length of the study period ranged from six months [60][61][62] to two years 63 , with the duration unclear for three studies. 56,57,65 The number of contacts provided to consumers was clear in only one study (6 sessions over 6 months).…”

Interventions supporting community nurses in the provision of Oral healthcare to people living at home: a scoping review

“…These individuals are at a high risk of developing poor oral health and current NICE [25] guidance recommends that health and social care services need to provide support, in the form of health promotion, assessment and care-planning, to these people at risk. Community nurses are frequently the first point of contact with these patients, and as such, it is important that they have requisite knowledge and competence to support patients in their own home to maintain good oral healthcare [26][27][28]. However, the use of specific tailored approaches to support the oral healthcare of people living at home requiring community nursing support remains unclear [29].…”