S49: Engaging patients with serious mental illness (SMI) in self-management care planning- based physical health interventions: what works (or not) and why?

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By September 11, 2019 No Comments

Authors: Sara Zabeen, Sharon Lawn, Anthony Venning, Kate Fairweather-Schmidt, David Smith

Year: 2019

Event: 2019 TheMHS Conference

Subject: Engaging patients with serious mental illness (SMI) in self-management care planning- based physical health interventions: what works (or not) and why?

Type of resource: Conference Presentations and Papers



Ms Sara Zabeen is a second year PhD student and a casual Research Fellow at Flinders Human Behaviour & Health Research Unit (FHBHRU). Her doctoral research investigates the acceptability and feasibility of Flinders Program in people with serious mental illness. Her other research interests are: health promotion, and community development.

Flinders Program is a self-management based intervention, currently being trialled among patients with SMI and cardiovascular risk factors in South Australia [Battersby et al., 2018]. This presentation will describe initial findings of a longitudinal qualitative investigation of the program’s acceptability and feasibility, conducted alongside the quantitative component. Preliminary themes derived from 29 patients’ and carers’ in-depth interviews suggest patients’ historical relationship with mental health services is a key contributing factor underpinning patients’ lack of trust and interest in engaging in new interventions. This includes traumatic experiences at tribunals, medication-reliant treatment, and lack of continuity in care. Critical Realism-based analysis [Bhaskar, 1979] of seven mental health staff interviews identifies current service culture and change fatigue are key reasons hindering staff from providing quality care. Despite these challenges, the Flinders Program seems to potentiate a positive influence among patients who are: a) mentally stable; b) motivated; c) have encouraging family; and/or d) have non-government organisations’ support. Patients also conveyed that trial nurses’ genuine interest in their wellbeing and empathy, and one-to-one delivery processes were prime motivational factors of engagement into the program. Early indications are suggestive of the need for structural change at systems level, to promote cultural change towards recovery-oriented service.

Learning Objectives
Learning Objective 1: Self-management based physical health intervention WORKS for people with SMI- but under certain circumstances
Learning Objective 2: A structural level change will take long time but desirable. Meanwhile, all service providers (mental health staff, GPs, NGOs) and community members (especially family members) need to be more empathetic and encouraging in promoting HOPE- even these small steps can eventually change the bigger picture

Battersby, M., Kidd, M. R., Licinio, J., Aylward, P., Baker, A., Ratcliffe, J., Quinn, S., Castle, D.J., Zabeen, S., Fairweather-Schmidt, A.K., & Lawn, S. (2018). Improving cardiovascular health and quality of life in people with severe mental illness: study protocol for a randomised controlled trial. Trials, 19(1), 366.
Bhaskar, R. (1979). Philosophy and the Human Sciences: A Philosophical Critique of the Contemporary Human Sciences. The Possibility of Naturalism. Harvester Press.

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