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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.

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