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Improving the Physical Health of People with a Mental Illness

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 17533

Special Issue Editors

School of Psychological Science, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia
Interests: resilience; child and adolescent mental health; adult mental health; priority populations; health inequalities; integrated mental and physical health care; broader health behavior; chronic disease prevention and health promotion research; implementation science; preventive care; systematic reviews; rapid reviews and meta-analyses
School of Psychological Science, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia
Interests: health service delivery; mental health services; integrated mental and physical health care; health behaviours; chronic disease prevention; preventive care; health promotion
NIHR Applied Research Collaborations Mental Health Priority Network at Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
Interests: implementation science; global health; mental health research; integrated mental and physical health care; health inequalities; mixed methods research
The Macquarie University Centre for the Health Economy (MUCHE), Suite 3-4, Level 1 EMC2 Building 3, Innovation Rd, Macquarie Park, NSW 2109, Australia
Interests: causal inference; policy evaluation; mental health; aged care; maternal health; health behaviours; private health insurance

Special Issue Information

Dear Colleagues,

People with mental illness experience significantly higher morbidity and mortality compared to people without. Globally, this is commonly reported as linked to preventable chronic disease and modifiable health risk behaviours, with approaches that target the physical health of people with a mental illness identified as a priority for national and international efforts.

This Special Issue welcomes papers of all study designs and from all world regions aimed at reducing inequity in physical health for people with a mental health condition. This includes work relating to reducing the prevalence of health risk behaviours and improving care for these and associated chronic diseases in people with a mental illness, particularly integrated care protocols for co-occurring mental illness and substance misuse, mental health care access for people with long term physical health concerns, other underserved areas and health care inequalities, and emerging care settings such as community managed, or third sector, organisations. We welcome a variety of articles focusing on, but not limited to co-design and/or co-development, service-user involvement, collaborative clinical care, implementation programs and interventions including addressing scaling up, effective translation of evidence into practice, sustainability, cost and/or economic evaluations, evidence syntheses, health system strengthening including integration of healthcare, health information systems and health indicators to address both physical and mental health, healthcare access, scale of physical health checks for people with mental health problems, innovative research designs and collaborative partnerships, and bridging research to practice to policy gaps. 

Dr. Julia Dray
Dr. Caitlin Fehily
Dr. Shalini Ahuja
Dr. Anam Bilgrami
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mental health
  • physical health
  • integration
  • health risk behaviours
  • chronic disease prevention
  • health inequalities
  • priority populations

Published Papers (8 papers)

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11 pages, 1306 KiB  
Communication
The Potential Impact of a Public Health Approach to Improving the Physical Health of People Living with Mental Illness
by Russell Roberts, Caroline Johnson, Malcolm Hopwood, Joseph Firth, Kate Jackson, Grant Sara, John Allan, Rosemary Calder and Sam Manger
Int. J. Environ. Res. Public Health 2022, 19(18), 11746; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811746 - 17 Sep 2022
Cited by 3 | Viewed by 2105
Abstract
With already wide disparities in physical health and life expectancy, COVID-19 presents people with mental illness with additional threats to their health: decreased access to health services, increased social isolation, and increased socio-economic disadvantage. Each of these factors has exacerbated the risk of [...] Read more.
With already wide disparities in physical health and life expectancy, COVID-19 presents people with mental illness with additional threats to their health: decreased access to health services, increased social isolation, and increased socio-economic disadvantage. Each of these factors has exacerbated the risk of poor health and early death for people with mental illness post-COVID-19. Unless effective primary care and preventative health responses are implemented, the physical illness epidemic for this group will increase post the COVID-19 pandemic. This perspective paper briefly reviews the literature on the impact of COVID-19 on service access, social isolation, and social disadvantage and their combined impact on physical health, particularly cancer, respiratory diseases, heart disease, smoking, and infectious diseases. The much-overlooked role of poor physical health on suicidality is also discussed. The potential impact of public health interventions is modelled based on Australian incidence data and current research on the percentage of early deaths of people living with mental illnesses that are preventable. Building on the lessons arising from services’ response to COVID-19, such as the importance of ensuring access to preventive, screening, and primary care services, priority recommendations for consideration by public health practitioners and policymakers are presented. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
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15 pages, 3150 KiB  
Article
Influence of Initial Severity of Depression on the Effectiveness of a Multimodal Therapy on Depressive Score, Heart Rate Variability, and Hemodynamic Parameters
by Sascha Ketelhut, Emanuel Wehlan, Gerhart Bayer and Reinhard G. Ketelhut
Int. J. Environ. Res. Public Health 2022, 19(16), 9836; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19169836 - 10 Aug 2022
Cited by 1 | Viewed by 1654
Abstract
Depression is a major cause of disability among populations worldwide. Apart from primary symptoms, depressed patients often have a higher cardiovascular risk profile. Multimodal therapy concepts, including exercise, have emerged as promising approaches that not only improve depressive symptoms but also have a [...] Read more.
Depression is a major cause of disability among populations worldwide. Apart from primary symptoms, depressed patients often have a higher cardiovascular risk profile. Multimodal therapy concepts, including exercise, have emerged as promising approaches that not only improve depressive symptoms but also have a positive impact on cardiovascular risk profile. However, controversies have arisen concerning the influence of baseline severity on the effects of therapy concepts for this demographic. This study assessed whether pretreatment severity moderates psychological and physiological treatment outcomes of a multimodal therapy. A total of 16 patients diagnosed with mild depression (MD) and 14 patients diagnosed with severe depression (SD) took part in a 3-month outpatient multimodal treatment therapy. Before and after the treatment, depression score (Beck Depression Inventory (BDI)), peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), heart rate (HR), and parasympathetic parameters of heart rate variability (RMSSD) were assessed. Significant time effects were detected for BDI (−20.0 ± 11.6, p > 0.001, η2 = 0.871), pSBP (−4.7 ± 6.8 mmHg, p < 0.001, η2 = 0.322), pDBP (−3.5 ± 6.9 mmHg, p = 0.01, η2 = 0.209), cSBP (−4.8 ± 6.5 mmHg, p < 0.001, η2 = 0.355), cDBP (−3.6 ± 6.8 mmHg, p = 0.008, η2 = 0.226), PWV (−0.13 ± 0.23 m/s, p = 0.008, η2 = 0.229), HR (4.3 ± 8.8 min−1, p = 0.015, η2 = 0.193), RMSSD (−12.2 ± 23.9 ms, p = 0.017, η2 = 0.251), and and SDNN (10.5 ± 17.8 ms, p = 0.005, η2 = 0.330). Significant time × group interaction could be revealed for BDI (p < 0.001, η2 = 0.543), with patients suffering from SD showing stronger reductions. Pretreatment severity of depression has an impact on the effectiveness of a multimodal therapy regarding psychological but not physiological outcomes. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
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18 pages, 394 KiB  
Article
Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study
by Kathryn A. Richardson, Christine L. McKibbin, Barbara S. Dabrowski, Elizabeth L. A. Punke and Cynthia M. Hartung
Int. J. Environ. Res. Public Health 2022, 19(13), 8057; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19138057 - 30 Jun 2022
Cited by 1 | Viewed by 1250
Abstract
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory [...] Read more.
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
13 pages, 541 KiB  
Article
Results of a Qualitative Study Aimed at Building a Programme to Reduce Cardiovascular Risk in People with Severe Mental Illness
by Marie Costa, Nicolas Meunier-Beillard, Elise Guillermet, Lucie Cros, Vincent Demassiet, Wendy Hude, Anna Baleige, Jean-François Besnard, Jean-Luc Roelandt and Frédéric Denis
Int. J. Environ. Res. Public Health 2022, 19(11), 6847; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19116847 - 03 Jun 2022
Cited by 1 | Viewed by 1337
Abstract
People with severe mental illness (PSMI) have a shorter life expectancy and are more likely to have cardiovascular disease than the general population. Patients, carers, psychiatric professionals and primary care providers can all play a role in increasing PSMI physical health. The present [...] Read more.
People with severe mental illness (PSMI) have a shorter life expectancy and are more likely to have cardiovascular disease than the general population. Patients, carers, psychiatric professionals and primary care providers can all play a role in increasing PSMI physical health. The present qualitative exploratory study aimed to explore the views of these four populations as part of the multi-phase COPsyCAT project, whose objective is to build and test a cardiovascular risk prevention programme for PSMI. Overall, 107 people participated in the study’s 16 focus groups, which were transcribed and analysed in a thematic analysis. With a view to building the health promotion programme, major themes identified in the corpus were translated into a list of needs as follows: communication, information, training and support. Results show that it is essential to improve communication between all the different stakeholders in mental health. The greatest challenge facing this programme will be to adapt it to the needs and expectations of PSMI while facilitating work between the various mental health stakeholders. Simple and inexpensive actions could be taken to improve the cardiovascular health of PSMI and will be experimented with during the programme’s feasibility study which will start in September 2022. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
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15 pages, 471 KiB  
Article
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
by Julia Dray, Lauren Gibson, Tara Clinton-McHarg, Emma Byrnes, Olivia Wynne, Kate Bartlem, Magdalena Wilczynska, Joanna Latter, Caitlin Fehily, Luke Wolfenden and Jenny Bowman
Int. J. Environ. Res. Public Health 2022, 19(9), 5533; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095533 - 02 May 2022
Cited by 1 | Viewed by 2138
Abstract
People living with mental health conditions experience a significantly reduced life expectancy compared to people without, largely linked to health risk behaviours and associated chronic disease. Community managed organisations (CMOs) represent an important setting in which to address health risk behaviours among people [...] Read more.
People living with mental health conditions experience a significantly reduced life expectancy compared to people without, largely linked to health risk behaviours and associated chronic disease. Community managed organisations (CMOs) represent an important setting in which to address health risk behaviours among people with mental health conditions. However, little is known about how these behaviours (smoking, poor nutrition, alcohol consumption, inadequate physical activity, poor sleep: SNAPS) are being addressed in this setting. One-on-one, semi-structured telephone interviews were conducted with a sample of 12 senior staff, representing 12 CMOs in New South Wales, Australia to: (1) explore types of support provided by CMOs to address the SNAPS behaviours of consumers living with a mental health condition; and (2) assess perceived organisational and staff level barriers and facilitators to providing such support. Transcribed interviews were analysed using inductive thematic analysis. This study found there was a range of supports offered by CMOs, and these differed by health risk behaviour. Findings suggest CMOs are well-placed to embed SNAPS supports as a part of their service provision; however, available funding, consistency of supports, workplace policies and culture, collaboration with other available supports, staff training and education, all impacted capacity. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
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14 pages, 357 KiB  
Article
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
by Tara Clinton-McHarg, Lauren Gibson, Kate Bartlem, Sonya Murray, Jade Ryall, Mark Orr, Janet Ford and Jenny Bowman
Int. J. Environ. Res. Public Health 2022, 19(8), 4458; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084458 - 07 Apr 2022
Cited by 1 | Viewed by 1731
Abstract
People living with mental health conditions experience a reduced life expectancy largely due to a higher prevalence of chronic diseases. Addressing health risk behaviours, including tobacco smoking, inadequate nutrition, harmful alcohol consumption, and physical inactivity (SNAP), through the provision of preventive care, is [...] Read more.
People living with mental health conditions experience a reduced life expectancy largely due to a higher prevalence of chronic diseases. Addressing health risk behaviours, including tobacco smoking, inadequate nutrition, harmful alcohol consumption, and physical inactivity (SNAP), through the provision of preventive care, is recommended to reduce this burden. Community Managed Organisations (CMOs) may play an important role in providing preventive care to consumers with mental health conditions, however, few studies have examined preventive care provision in CMO settings; and no studies have comprehensively assessed barriers to the provision of this care using a tool such as the Theoretical Domains Framework (TDF). To fill this research gap, we conducted an online survey among staff (N = 190) from one CMO in Australia to (1) identify barriers to preventive care provision (ask, advise, assist, connect) to address SNAP behaviours among consumers; and (2) explore associations between barriers and preventive care provision. Results demonstrate that while staff reported knowing how to provide preventive care and believed it would positively impact consumers; barriers including confidence in providing this care and consumer uptake of referrals, were identified. Further research among multiple CMOs is needed to identify care provision and associated barriers in the sector more widely. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
18 pages, 371 KiB  
Article
Men’s Perceptions of a Gender-Tailored eHealth Program Targeting Physical and Mental Health: Qualitative Findings from the SHED-IT Recharge Trial
by Ryan J. Drew, Philip J. Morgan, Frances Kay-Lambkin, Clare E. Collins, Robin Callister, Brian J. Kelly, Vibeke Hansen and Myles D. Young
Int. J. Environ. Res. Public Health 2021, 18(24), 12878; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182412878 - 07 Dec 2021
Cited by 3 | Viewed by 2158
Abstract
Despite increasing rates of co-morbid depression and obesity, few interventions target both conditions simultaneously, particularly in men. The SHED-IT: Recharge trial, conducted in 125 men with depressive symptoms and overweight or obesity, tested the efficacy of a gender-tailored eHealth program with integrated mental [...] Read more.
Despite increasing rates of co-morbid depression and obesity, few interventions target both conditions simultaneously, particularly in men. The SHED-IT: Recharge trial, conducted in 125 men with depressive symptoms and overweight or obesity, tested the efficacy of a gender-tailored eHealth program with integrated mental health support. The aims of this study were to examine the perceptions of men who received the SHED-IT: Recharge intervention in relation to recruitment, satisfaction with the program, and suggestions to improve the program. Individual semi-structured interviews were conducted in a random sub-sample, stratified by baseline depression and weight status (n = 19, mean (SD) age 49.6 years (11.6), PHQ−9 score 9.0 (3.7), BMI 32.5 kg/m2 (4.6)). Transcripts were analyzed using an inductive process by an independent qualitative researcher. Four themes emerged, namely, (i) specific circumstances determined men’s motivation to enroll, (ii) unique opportunity to implement sustained physical and mental health changes compared to previous experiences, (iii) salience of the program elements, and (iv) further opportunities that build accountability could help maintain focus. Gender-tailored, self-directed lifestyle interventions incorporating mental health support are acceptable and satisfying for men experiencing depressive symptoms. These findings provide important insights for future self-guided lifestyle interventions for men with poor physical and mental health. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)

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19 pages, 1414 KiB  
Study Protocol
The Effectiveness and Cost of an Intervention to Increase the Provision of Preventive Care in Community Mental Health Services: Protocol for a Cluster-Randomized Controlled Trial
by Caitlin Fehily, Emma McKeon, Tegan Stettaford, Elizabeth Campbell, Simone Lodge, Julia Dray, Kate Bartlem, Penny Reeves, Christopher Oldmeadow, David Castle, Sharon Lawn and Jenny Bowman
Int. J. Environ. Res. Public Health 2022, 19(5), 3119; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19053119 - 07 Mar 2022
Viewed by 2944
Abstract
Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention [...] Read more.
Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician; (2) embedding information regarding risk factors into clients’ care plans; and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity); (2) brief advice regarding relevant risk behaviours; and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery. Full article
(This article belongs to the Special Issue Improving the Physical Health of People with a Mental Illness)
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