Pathways to Preventive Care for People with Severe Mental Illness

Project Status
Current

Chief investigator
Catherine Spooner

Team members
Prof Mark Harris, A/Prof Ben Harris-Roxas, Jane Taggart, Sharon Parker, Louise Thomas, Prof Karen Fisher(Social Policy Research Centre), Dr Peri O’Shea (Social Policy Research Centre), A/Prof Patrick Bolton (UNSW Medicine)

Project Rationale

People with severe mental illness (PWSMI) have poorer physical health and a 13-30 year shorter life expectancy than the general population. The majority of deaths are due to preventable diseases such as obesity, cardiovascular disease and diabetes. There is a need to improve access to, and the quality of, preventive health care for PWSMI to improve their physical health outcomes. General practice is a key provider and coordinator of preventive health services. 

Project Aim/s

The project aimed to increase knowledge of the experiences and perspectives of PWSMI and what has helped or enabled them to establish and maintain a positive relationship with a GP. 

Project Design and Method

Research Question: What helps PWSMI to establish and maintain a positive relationship with their GP in order to prevent, detect and manage long-term physical conditions?

Study Design/methods: The study will include two components:

  1. Consumer and Carer consultations: Individual consultations and a workshop.
  2. Knowledge exchange and translation with consumers and providers.

Component 1. Consumer and Carer consultations

Ten consumers will participate in individual interviews and up to ten will participate in a ‘Consumer Journey Mapping’ Workshop. Up to five ‘matched’ carers or family members will be interviewed (via phone) with the consumers’ permission.

Sample: The criteria for study participation restricts the sample to: PWSMI and family/carers; currently or previously engaged with mental health services; adult (18 years +); and people who have accessed a GP or other health-care service in the last two years.

Recruitment: Consumers will be recruited via purposive sampling from Eastern Suburbs mental health services. Recruitment will be monitored to achieve a broad range of consumers e.g. gender, age, location, and level of engagement with GP. Carers will be recruited through consumer participants.

Data collection methods: To ensure the ability of PWSMI to contribute their insights, a mixed-methods approach will be used. Innovative methods will be trialled and adapted as necessary by an experienced consumer researcher.

Individual method: Case-study interviews, recorded (with permission) and transcribed. These interviews will be adapted to the preferences and capacity of the person with story-telling being a flexible, descriptive undertaking that can combine verbal with other art forms. Interviews with carers will be by phone, separate from PWSMI.

Group method: The group-based activity will explore consumers’ positive experiences with GPs through consumer journey mapping. Methods such as blue-sky preferences and storyboards will be used to generate new thinking. The group methods will build on the individual consumer mapping, facilitating a collective consciousness of experiences.

Consistent with an asset-based approach (or appreciative enquiry), the interviews and workshop will focus on good experiences and preferences for positive GP connections to inform future service/program design improvement.

Component 2. Knowledge exchange & translation workshop

Workshop will involve consumers, carers, mental health service providers, Primary Health Networks, GPs and others engaged in providing physical health services for PWSMI. The workshop will include a presentation of the results of the consumer consultations and discussion of what this means for services. Recommendations for planning and further research will be made with the participants.

Setting: Data collection will be focused in South-East Sydney Local Health District.

Ethical compliance: Ethical clearance will be obtained from the UNSW Human Research Ethics Committee and the SESLHD Ethics Committee.

Outcomes

The project led to strengthened partnerships within UNSW and with SESLHD. These have enabled and supported applications for funding from multiple sources including the UNSW Scientia PhD scholarship program, the Medical Research Future Fund, the NSW Government Translational Research Grants Scheme, the Mental Health Commission of New South Wales, and the NHMRC Special Initiative in Mental Health.

The project developed a summary report that was send to all study participants:

Consumer consultations and knowledge exchange workshop summary for participants