Abstract
Author(s)
Andy Simpson
People living with severe mental illness live 14-23 years less than the population average due mainly to treatable physical health comorbidities, yet receive poorer quality physical health care. To address this, Sydney Local Health District introduced the Living Well, Living Longer (LWLL) program, which uses a plethora of integrated care initiatives to guide individuals through the four stages of screening, detection, initiation of treatment and ongoing management.
These include:
1. The Collaborative Centre for Cardiometabolic Health in Psychosis (ccCHiP), a one-stop shop multidisciplinary clinic that provides comprehensive assessment of cardiometabolic risk and formulates treatment recommendations.
2. The Mental Health Shared Care (MHSC) program formalises care arrangements between GPs and mental health services guided by the shared care checklist, which defines the responsibilities of the mental health team and the GP while ensuring care reviews and prescribed medications are communicated within a comprehensive annual cycle of care.
3. Community lifestyle clinicians, namely dietitians, exercise physiologists, and smoking cessation officers have been employed to work with consumers to develop individualised achievable and relevant health behaviour change goals and support the practical strategies required to achieve these.
Since program commencement in 2014, over 1100 unique individuals have been reviewed at ccCHiP, 1200 enrolled in MHSC, and over 2100 have engaged with the lifestyle clinicians. A power-calculated sample of 251 consumers, representative of the community mental health population, was compared between 2016 and 2020. Average Body Mass Index improved from 30.6 to 29kg/m2 (p=0.047), a shift from the obese range to the overweight range. Low Density Lipoproteins reduced from 2.88 to 2.60 (p=0.014) and the proportion of people with elevated blood sugars (HbA1c) reduced from 45% to 30% (p=0.025). People who engaged with the LWLL interventions were more likely to show health improvements. These outcomes and future directions of the program will be discussed.