A well-being programme in severe mental illness. Reducing risk for physical ill-health: a post-programme service evaluation at 2 years.
BACKGROUND
Cardiovascular disease is more prevalent in patients with severe mental illness (SMI) than in the general population.


METHODS
Seven geographically diverse centres were assigned a nurse to monitor the physical health of SMI patients in secondary care over a 2-year period in the "Well-being Support Programme" (WSP). A physical health screen was performed and patients were given individual weight and lifestyle advice including smoking cessation to reduce cardiovascular risk.


RESULTS
Nine hundred and sixty-six outpatients with SMI >2 years were enrolled. The completion rate at 2 years was 80%. Significant improvements were observed in levels of physical activity (p<0.0001), smoking (p<0.05) and diet (p<0.0001). There were no changes in mean BMI although 42% lost weight over 2 years. Self-esteem improved significantly. Low self-esteem decreased from 43% at baseline to 15% at 2 years (p<0.0001). At the end of the programme significant cardiovascular risk factors remained, 46% of subjects smoked, 26% had hypertension and 81% had BMI >25.


CONCLUSIONS
Physical health problems are common in SMI subjects. Many patients completed 2 years follow up suggesting that this format of programme is an acceptable option for SMI patients. Cardiovascular risk factors were significantly improved. Interventions such as the Well-being Support Programme should be made widely available to people with SMI.
Smith
Shubulade
S
PO Box 23, Institute of Psychiatry, Decrespigny Park, Camberwell, London, SE5 8AF, UK. s.smith@iop.kcl.ac.uk
Yeomans
David
D
Bushe
Chris J P
CJ
Eriksson
Cecilia
C
Harrison
Tom
T
Holmes
Robert
R
Mynors-Wallis
Laurence
L
Oatway
Helen
H
Sullivan
Gary
G
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D016730:Program Development; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012649:Self Concept; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D013997:Time Factors