title: Active steps towards a healthier life for people with severe mental illness: a qualitative approach to understanding the potential for implementing change.
abstract: OBJECTIVE
  Our health systems are failing to provide optimal physical care for people with severe mental illness. To address this gap, Queensland Health and General Practice Queensland in partnership developed a comprehensive package of guidelines and health messages. However, guidelines alone are likely to be inadequate motivators of change. The objective of this research was to qualitatively explore key stakeholders' expectations about the implementation of guidelines, with the purpose of identifying interventions to support practice change.
  
  
  METHODS
  Participants wer recruited from the partnership governance committee. A semistructured interview guide was used to gather data. Using grounded-theory techniques, the data were analysed to identify key themes.
  
  
  RESULTS
  All stakeholders agreed that the purpose of developing comprehensive guidelines and health messages was to achieve change through innovation and the promotion of early intervention, reduction of avoidable admissions and sectoral integration. However, existing structures within the system were considered to be insurmountable barriers.
  
  
  CONCLUSIONS
  Key stakeholders sought broader change than just guidelines and health messages developed by the partnership focussed specifically on awareness-raising about the physical care of people with severe mental illness. However, there was no clear consensus as to what that change should be. This mismatch between the goals and actions of such a large-scale initiative is problematic. Suggestions are made about how to address change.
authors.affiliation: Population and Social Health Research Program, Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Qld 4131, Australia. Email:
authors.forename: Carolyn
authors.initials: C
authors.lastname: Ehrlich
authors.forename: Steve
authors.initials: S
authors.lastname: Kisely
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kendall
authors.forename: David
authors.initials: D
authors.lastname: Crompton
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Crowe
authors.forename: Ann Maree
authors.initials: AM
authors.lastname: Liddy
mesh_terms: D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D009909:Oral Health; D036301:Qualitative Research; D011793:Queensland; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index