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RESEARCH ARTICLE
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The Living Well, Living Longer program: an integrated care strategy to improve the health of people living with severe mental illness

Andrew Simpson https://orcid.org/0009-0005-3273-2374 A * , Lisa Parcsi A and Andrew McDonald B
+ Author Affiliations
- Author Affiliations

A Sydney Local Health District, Department of Clinical Services Integration, RPA Hospital, KGV Building, Missenden Road, Camperdown, NSW 2050, Australia.

B Sydney Local Health District, Mental Health Services, Concord Centre for Mental Health, 109 Hospital Road, Concord, NSW 2139, Australia.

* Correspondence to: andysimpson6@gmail.com

Australian Health Review https://doi.org/10.1071/AH24169
Submitted: 14 June 2024  Accepted: 19 September 2024  Published: 14 October 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Living Well, Living Longer (The Program) is an integrated care strategy to improve the physical health of people living with severe mental illness within a public mental health service. The significant life expectancy gap experienced by this cohort is largely attributed to higher rates of cardiovascular disease and modifiable risk factors. The Program addresses this by guiding people through the four stages of screening, detection, treatment initiation, and ongoing management of coexisting chronic health conditions. The Program adopted an integrated care approach to ensure the provision of appropriate and coordinated care across hospital and primary care services. Key care pathways include a cardiometabolic health assessment clinic, shared care with general practitioners, oral health services partnership and employment of peer support workers, dietitians, exercise physiologists, and smoking cessation to provide targeted community support and interventions. There has been strong engagement with the care pathways introduced since The Program’s inception in 2013 and evaluation is currently underway to consider the impact on cardiometabolic health outcomes for participants. Critical to The Program’s effectiveness has been engagement with lived experience expertise, multidisciplinary collaboration, and strong executive support. However, significant challenges persist amid an Australian public health crisis characterised by reducing rates of free primary healthcare access for people living with severe mental illness and enduring communication challenges between primary and secondary health services. With the implementation of MyMedicare and the imminent Single Digital Patient Record across NSW Health, we stand at a critical juncture. It is imperative to establish robust systems to enhance care for this vulnerable population.

Keywords: cardiometabolic health, chronic disease management, comorbidity, health screening, integrated care, lifestyle activities, lived experience, mental health, mental health services, peer support workers, premature mortality, severe mental illness, shared care.

References

1  National Mental Health Commission. Equally Well Consensus Statement: Improving the physical health and wellbeing of people living with mental illness in Australia. Sydney: NMHC; 2016.

2  DE Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 2011; 10(1): 52-77.
| Crossref | Google Scholar | PubMed |

3  Mangurian C, Newcomer JW, Modlin C, Schillinger D. Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review. J Gen Intern Med 2016; 31(9): 1083-1091.
| Crossref | Google Scholar | PubMed |

4  Morgan M, Peters D, Hopwood M, Castle D, Moy C, Fehily C, Sharma A, Rocks T, Mc Namara K, Cobb L, Duggan M, Dunbar JA, Calder R. Better physical health care and longer lives for people living with serious mental illness. Melbourne: Mitchell Institute, Victoria University; 2021.

5  Calder RV, Dunbar JA, de Courten MP. The Being Equally Well national policy roadmap: providing better physical health care and supporting longer lives for people living with serious mental illness. Med J Aust 2022; 217(7): S3-S6.
| Crossref | Google Scholar | PubMed |

6  Lambert TJ, Reavley NJ, Jorm AF, Oakley Browne MA. Royal Australian and New Zealand College of Psychiatrists expert consensus statement for the treatment, management and monitoring of the physical health of people with an enduring psychotic illness. Aust N Z J Psychiatry 2017; 51(4): 322-337.
| Crossref | Google Scholar | PubMed |

7  Curtis J, Teasdale SB, Morell R, et al. Implementation of a lifestyle and life-skills intervention to prevent weight-gain and cardiometabolic abnormalities in young people with first-episode psychosis as part of routine care: The Keeping the Body in Mind program. Early Interv Psychiatry 2024; 18(9): 731-738.
| Crossref | Google Scholar | PubMed |

8  Kritharides L, Chow V, Lambert TJ. Cardiovascular disease in patients with schizophrenia. Med J Aust 2017; 207(4): 179.
| Crossref | Google Scholar | PubMed |

9  Etta I, Kambham S, Girigosavi KB, Panjiyar BK. Mouth-Heart Connection: A Systematic Review on the Impact of Periodontal Disease on Cardiovascular Health. Cureus 2023; 15(10): e46585.
| Crossref | Google Scholar | PubMed |

10  McBride KE, Solomon MJ, Young JM, et al. Impact of serious mental illness on surgical patient outcomes. ANZ J Surg 2018; 88: 673-677.
| Crossref | Google Scholar | PubMed |

11  McBride KE, Solomon MJ, Bannon PG, Glozier N, Steffens D. Surgical outcomes for people with serious mental illness are poorer than for other patients: a systematic review and meta-analysis. Med J Aust 2021; 214(8): 379-385.
| Crossref | Google Scholar | PubMed |

12  McBride KE, Solomon MJ, Lambert T, et al. Surgical experience for patients with serious mental illness: a qualitative study. BMC Psychiatry 2021; 21(1): 47.
| Crossref | Google Scholar | PubMed |

13  McBride KE, Steffens D, Lambert T, Glozier N, Roberts R, Solomon MJ. Acceptability and face validity of two mental health screening tools for use in the routine surgical setting. BMC Psychol 2021; 9(1): 171.
| Crossref | Google Scholar | PubMed |

14  McBride K, Solomon M, Steffens D, Bannon P, Glozier N. Mental illness and surgery: do we care? ANZ J Surg 2019; 89: 630-631.
| Crossref | Google Scholar | PubMed |

15  Maylea C, Roberts R, Peters D, editors. Equally Well in Action: Implementing strategies to improve the physical health of people living with mental illness. Proceedings of the First National Equally Well Symposium, Melbourne: RMIT, Charle; 2019.

16  Bartlem KM, Bowman JA, Bailey JM, et al. Chronic disease health risk behaviours amongst people with a mental illness. Aust N Z J Psychiatry 2015; 49(8): 731-741.
| Crossref | Google Scholar | PubMed |

17  Gillespie J. Health of the Nation Report. National General Practitioner Listings. 2023. Available at https://cleanbill.com.au/wp-content/uploads/2023/04/Cleanbill-Health-of-the-Nation-Report-April-2023-1.pdf

18  Parker SM, Paine K, Spooner C, Harris M. Barriers and facilitators to the participation and engagement of primary care in shared-care arrangements with community mental health services for preventive care of people with serious mental illness: a scoping review. BMC Health Serv Res 2023; 23(1): 977.
| Crossref | Google Scholar | PubMed |

19  Saxena S. Excess mortality among people with mental disorders: a public health priority. Lancet Public Health 2018; 3(6): e264-e265.
| Crossref | Google Scholar | PubMed |

20  Liu NH, Daumit GL, Dua T, et al. Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry 2017; 16(1): 30-40.
| Crossref | Google Scholar | PubMed |