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ToolsTredget, Gracie, Williams, Julie, McGrath, Ray, Sadler, Euan, Gaughran, Fiona, Ang, Karen, Stepan, Natalia, Cross, Sean, Tweed, John, Orlando, Lia and Sevdalis, Nick and Integrating our Mental Physical Healthcare Systems (IMPHS) Study Team (2023) How is physical healthcare experienced by staff, service users, and carers in adult community mental health services in a south London mental health trust? A service evaluation. Frontiers in Health Services, 3. ISSN 2813-0146
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Abstract
Background: Adults with a serious mental illness (SMI) are at greater risk of physical health morbidity and premature death than the general population, largely as a result of preventable physical health issues. Staff working in mental health services have a role to play in addressing these inequalities, but little is known about how they perceive their role and how this impacts on their practice. Understanding this better would enable services to improve their approach and support better health outcomes for SMI patients. A service evaluation was undertaken to investigate how physical healthcare is approached within adult community mental health teams (CMHTs) at a South London (UK) Mental Health Trust. Methods: This was a prospective, cross-sectional evaluation design. Interviews and focus groups were conducted with clinical staff, service users and carers (non-professional caregivers e.g., family or friends, of adults living with an SMI), to understand their experiences and to identify key barriers and facilitators to supporting physical healthcare support for adults with SMI. Thematic analysis was conducted to identify key themes which were classified into five main categories. Results: 50 participants took part in the study, 38 were clinical staff, eight were service users and four were carers. We found staff widely recognised the importance of supporting physical healthcare. However, there was variability in how staff approached physical healthcare in routine practice, and differences in how physical healthcare is experienced by service users and carers. Staff were keen to engage in changes to the way physical healthcare is delivered in CMHTs. However, they sought clearer guidance on their roles and responsibilities, and wanted to better understand the rationale for changes in community mental health practice, such as increased screening for physical healthcare. Service users and carers felt equally that the role of CMHTs in physical healthcare was unclear, which limited their ability to access it and understand the benefit for their overall care. Staff articulated gaps in leadership and training that impacted on their ability to implement the overall vision for physical healthcare within the Trust. Conclusion: Mental health staff recognise the role they play in supporting the physical health of adults living with SMI. This evaluation provides insight into common barriers and facilitators faced by staff, service users and carers when providing or accessing physical healthcare within adult CMHTs. These findings indicate a more comprehensive and better articulated approach to physical healthcare in mental health Trusts is needed to ensure service users and their carers understand what support is available and how to access it and to equip staff to provide and sustain that care in routine practice.
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| Additional Information: | Funding Information: The evaluation was funded by the Maudsley Charity. NS and FG's research is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South London at King's College Hospital NHS Foundation Trust. NS is a member of King's Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King’s Health Partners (Guy's and St Thomas’ NHS Foundation Trust, King's College Hospital NHS Foundation Trust, King's College London and South London and Maudsley NHS Foundation Trust), and Guy's and St Thomas’ Foundation. ES is supported by NIHR ARC Wessex. RM is an ICA Pre-doctoral Clinical and Practitioner Academic Fellow supported by Health Education England and the NIHR Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, the ESRC or the Department of Health and Social Care. Acknowledgments Funding Information: The evaluation was funded by the Maudsley Charity. NS and FG's research is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South London at King's College Hospital NHS Foundation Trust. NS is a member of King's Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King’s Health Partners (Guy's and St Thomas’ NHS Foundation Trust, King's College Hospital NHS Foundation Trust, King's College London and South London and Maudsley NHS Foundation Trust), and Guy's and St Thomas’ Foundation. ES is supported by NIHR ARC Wessex. RM is an ICA Pre-doctoral Clinical and Practitioner Academic Fellow supported by Health Education England and the NIHR Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, the ESRC or the Department of Health and Social Care. Publisher Copyright: 2023 Tredget, Williams, McGrath, Sadler, Gaughran, Ang, Stepan, Cross, Tweed, Orlando, Sevdalis and the Integrating our Mental and Physical Healthcare Systems (IMPHS) Study Team. |
| Uncontrolled Keywords: | adults,community mental health teams,physical healthcare,serious mental illness (smi),service evaluation,medicine(all),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Behavioural and Implementation Science Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 07 Nov 2023 02:49 |
| Last Modified: | 04 Mar 2024 18:21 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/93580 |
| DOI: | 10.3389/frhs.2023.1125790 |
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