Andy has over 25 years of experience as a mental health nurse across inpatient and community settings, including 8 years in education and leadership roles. For the last four years he’s been the program manager with Living Well, Living Longer: Sydney Local Health District’s integrated care program aiming to improve the physical health of people living with severe mental illness.
Title: Evaluating the impact of the COVID-19 pandemic on the provision of physical health interventions to mental health consumers within Sydney Local Health District
Author(s): Andrew Simpson, Lisa Parcsi, Andrew McDonald
Introduction: People living with severe mental illness experience disproportionately high rates of morbidity and mortality compared with the general population. Sydney Local Health District introduced the Living Well, Living Longer program in 2013 to address this inequity. The COVID-19 pandemic impacted the provision of routine health services. This report evaluates the impact of the pandemic on the provision of physical health interventions to mental health consumers in Sydney Local Health District.
Method: Rates of COVID-19 vaccinations to consumers within Sydney Local Health District community mental health services were collated. Routinely collected service data was reviewed for changes in rates of metabolic monitoring, mental health shared care, physical health checks with general practitioners, cardiometabolic health clinic assessments, and diet and exercise interventions. A period from April 2019 to April 2022 was selected which enabled a comparison for 12 months pre-pandemic with 2 years peri-pandemic.
Results & Findings: 91.9% of consumers received at least two COVID-19 vaccinations and 61.3% received a booster. However there was a 37.3% reduction in rates of metabolic monitoring, 20.1% reduction in Mental Health Shared Care agreements, 60.6% reduction in physical health checks, 55.1% reduction in cardiometabolic clinic assessments, and 19.8% reduction of diet and exercise interventions. Up-to-date data will be presented at the symposium to see if any signs of recovery are emerging.
Discussion: The COVID-19 pandemic necessitated a whole of health system response to protect the community, but the requisite reallocation of resources came at a cost to routine service provision. The high rates of vaccinations achieved with mental health consumers in Sydney Local Health District should be commended, but there was a significant reduction in all other physical health interventions. A renewed focus is now required to increase physical health screening & intervention to minimise the potential impact of the pandemic on cardiometabolic morbidity and mortality in this population.
Title: Lessons from a shared-care trial with mental-health services, consumers and GPs
Author(s): Stella Jun, Andy Simpson, Catherine Spooner, Snow Li, Mark Harris, Kizzy Searle, Andrew McDonald, Andrew Baillie, Ben Harris-Roxas, Michelle Cunich, Jane Taggert, Nathalie Hansen, Lisa Parcsi, Beatriz Lopez Portillo
Introduction: Communication between healthcare providers is essential for improving the wellbeing of people experiencing severe and enduring mental illness. The SHAReD Study investigates the use of an online shared care tool for enhanced care planning and communication between mental health services (MHS), general practitioners (GPs), and their shared consumers within Sydney Local Health District (SLHD). This study explores the barriers experienced by different stakeholder groups during the recruitment and baseline interview period.
Method: This qualitative process evaluation of the randomised controlled trial draws on reports and reflections from the SHAReD study research team between March 2022 and July 2023.
Results & Findings: The study identified barriers to recruitment and baseline survey faced by different stakeholder groups. Mental health services faced capacity challenges related to high staff turnover –during the pandemic. GPs had limited capacity to trial anything new following the COVID-19 response and many were reluctant to introduce external software due to data privacy concerns. For consumers, some expressed, pre-existing mistrust with healthcare systems and many did not have a regular GP. These recruitment and engagement challenges pre-empted multiple changes in strategy during the study recruitment period, many of which required ethics amendments and changes to the consent process. The recruitment period was extended from 3 months to 9 months to enable these changes to be implemented.
Discussion: The barriers identified in this study illustrate the challenges and complexities of implementing shared-care interventions in the mental health sector. They also highlight the impact of COVID-19 on mental health services and GPs, which may affect the care that consumers receive. The study underscores the importance of considering the perspectives of all stakeholders. This may involve addressing the concerns and challenges faced by different stakeholder groups, including capacity issues, data privacy concerns, and the need for flexible recruitment and engagement strategies.