Abstract

Authors:

Caitlin Fehily, Kate Bartlem, John Wiggers, Paula Wye, Richard Clancy, David Castle, Sonia Wutzke, Chris Rissel, Andrew Wilson, and Jenny Bowman.

Background:
People with a mental illness are more likely to engage in modifiable risk behaviours: smoking, poor nutrition, harmful alcohol consumption and physical inactivity, compared to the general population. Guidelines recommend that mental health services routinely provide ‘preventive care’ to address risk behaviours, however, provision of this care is low. This study aimed to assess the effectiveness of providing preventive care via the offer of an additional consultation with a specialist preventive care clinician in a mental health service.

Methods:
A randomised controlled trial was conducted within one community mental health service. Clients (n=811) were randomised to receive either usual care (preventive care directed by policy to be provided in routine consultations) or usual care plus the offer of an additional consultation with a specialist preventive care clinician (intervention group). Telephone interviews were undertaken at baseline and a one-month follow-up to assess participants’ views towards this model and receipt of preventive care.

Results:
82% of the intervention group stated that this model of preventive care provision was acceptable, and 95% agreed that it was a good idea. One third of clients allocated to the intervention attended the preventive care consultation, and participants who attended reported high levels of satisfaction. Preliminary intention to treat analyses indicated that the intervention group were significantly more likely to have been asked about their risk behaviours (RR 4.00), advised to change at-risk behaviours (RR 2.40) and offered referral(s) to specialist behaviour change services (RR 20.13).

Conclusions:
Clients of a community mental health service viewed the offer of an additional preventive care consultation to be acceptable and satisfactory. This model of service delivery resulted in significantly greater receipt of preventive care, as compared to usual care. This model may be a means of providing care to clients of community mental health services worthy of further testing.