Julia Dray

Julia is an early career researcher currently working as a post-doctoral researcher with the Physical Health in Mental Illness (PHiMI) team at the University of Newcastle (UoN), Australia. The primary interest of the PHiMI team is to reduce inequity in physical health for people with a mental health condition, particularly improved chronic disease prevention. The team is engaged in a variety of research projects across local and national community mental health organisations, telephone support services and other mental health service settings. Julia completed her PhD (UoN; 2018), which focused on resilience and mental health problems in children and adolescents.

Abstract

Title: A qualitative investigation of support provided by Community Managed Organisations to address chronic disease risk behaviours in consumers with mental illness

Author(s): Dray J^1,2,3,4,5,6, Gibson L^1,35,6, Byrnes E^2,5, Wynne O^1,4,6, Bartlem K^1,3,4,5,6, Clinton-McHarg T^2,3,4,5,6, Wilczynska M^4,6, Latter J^1,3,5, Fehily C^1,3,4,5,6, Wolfenden L^2,3,4,5, Bowman J^1,3,4,5,6

¹School of Psychology, The University of Newcastle

²School of Medicine and Public Health, The University of Newcastle

³Priority Research Centre for Health Behaviour, The University of Newcastle

⁴Hunter New England Population Health, Hunter New England Local Health District

⁵Hunter Medical Research Institute

⁶The Australian Prevention Partnership Centre, Sax Institute

Introduction: People with mental illness experience significantly higher morbidity and mortality compared to people without. This is consistently reported as linked to increased chronic disease health risk behaviours (smoking, poor nutrition, harmful alcohol consumption, and inadequate physical activity; SNAP) in this priority population. Community Managed Organisations (CMOs) have ongoing contact with consumers, deliver a diverse range of services, and are a potentially important setting to address health risk behaviours for people with mental illness. A qualitative study was conducted to explore: 1) the type of support provided to address five key health risk behaviours (smoking, poor nutrition, alcohol consumption, inadequate physical activity, and poor sleep) of consumers with a mental health condition; and, 2) organisational and staff level barriers and facilitators to providing this support.

Method: One-on-one, semi-structured telephone interviews with standardised open-ended questions were conducted with a purposive sample of 12 senior management staff, across CMO’s, NSW, Australia. Three independent coders analysed transcribed interviews. Inductive thematic analysis was used to guide theme generation.

Results and findings: Qualitative analysis generated three major themes, the first being types of SNAPS supports that CMOs provided. Under this theme, differences in types of support were evident by SNAP factor, with support largely dependent on available service and client level funding, or client-activation/personalised care plans. The second and third theme related to barriers (lack of funding; lack of consistency in SNAPS support provided) and facilitators (workplace culture; collaboration with available supports; staff education and training) experienced when providing SNAPS supports.

Discussion: This study found that support strategies offered by CMOs differed by physical health risk behaviours, models of care and funding at both a service and consumer level. Much care provided in this context is patient led, being dependent on funding and inclusion of the health risk behaviours in the consumers care plans, particularly when linked to provision of NDIS support.