title: The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study.
abstract: BACKGROUND
  People with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases.
  
  
  METHODS
  A retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 - August 2013).
  
  
  RESULTS
  A total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options.
  
  
  CONCLUSIONS
  The results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.
authors.forename: Brian
authors.initials: B
authors.lastname: McKenna
authors.forename: Trentham
authors.initials: T
authors.lastname: Furness
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wallace
authors.forename: Brenda
authors.initials: B
authors.lastname: Happell
authors.forename: Robert
authors.initials: R
authors.lastname: Stanton
authors.forename: Chris
authors.initials: C
authors.lastname: Platania-Phung
authors.forename: Karen-leigh
authors.initials: KL
authors.lastname: Edward
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000523:psychology; D019090:Case Management / Q000458:organization & administration; D003156:Community Mental Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000378:metabolism; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008603:Mental Health; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D024382:Professional Role; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008077:Lipoproteins, LDL