title: Consensus building to improve the physical health of people with severe mental illness: a qualitative outcome mapping study.
abstract: BACKGROUND
  The poor physical health of people with severe mental illness (SMI) is often attributed to lifestyle, disease-related medication side effects and disparate provision of healthcare. The complexity and inexact nature of this issue prohibits the identification of a clear and concise causal pathway, which in turn leads to uncertainty and imprecision about the most appropriate action to address the problem. One proposed solution is to integrate care across multiple organisations and sectors through collaborative processes. The objective of this study was to identify collective pathways of action that were consensually developed and which could be initiated by clinicians to improve the physical health of people with severe mental illness.
  
  
  METHODS
  Eighteen participants from a service catchment area in Australia were involved in a consensus-building workshop. This resulted in participants identifying and committing to a range of collaborative actions and processes to improve the physical health of people with severe mental illness. Consensus building was combined with an outcome mapping process, which has previously been used to facilitate health system integration. Data from the consensus-building workshop were thematically analysed and used to create an outcome map.
  
  
  RESULTS
  Participants identified that accessible, continuous, holistic, consumer-driven, recovery-oriented care was required if improved physical health of people with SMI were to be achieved. However, this all-encompassing care was dependant on a wide-ranging philosophical shift in two areas, namely societal stigma and the dominance of pharmacological approaches to care. Participants believed that this shift was contingent on the attitude and behaviours of healthcare professionals and would require an inclusive, networked approach to care delivery and maximal utilization of existing funding.
  
  
  CONCLUSIONS
  Rarely do multiple stakeholders from different sectors within the healthcare system have the opportunity to come together and create a collective vision for improving the health of a specific population in a defined area. We used a consensus building approach to generate solutions, actions and goal statements, which were then used to create a visual map that provided a purpose and signposts for action, thereby maximising the potential for cohesive action across sectors.
authors: Centre of National Research on Disability and Rehabilitation, Menzies Health Institute, Queensland, Griffith University, Logan Campus, Meadowbrook, QLD, 4131, Australia. c.ehrlich@griffith.edu.au.
authors: Carolyn
authors: C
authors: Ehrlich
authors: Centre of National Research on Disability and Rehabilitation, Menzies Health Institute, Queensland, Griffith University, Logan Campus, Meadowbrook, QLD, 4131, Australia. e.kendall@griffith.edu.au.
authors: Elizabeth
authors: E
authors: Kendall
authors: Centre of National Research on Disability and Rehabilitation, Menzies Health Institute, Queensland, Griffith University, Logan Campus, Meadowbrook, QLD, 4131, Australia. n.frey@griffith.edu.au.
authors: Nicolette
authors: N
authors: Frey
authors: Centre of National Research on Disability and Rehabilitation, Menzies Health Institute, Queensland, Griffith University, Logan Campus, Meadowbrook, QLD, 4131, Australia. m.denton@griffith.edu.au.
authors: Michelle
authors: M
authors: Denton
authors: School of Medicine, University of Queensland, St Lucia Campus, Brisbane, QLD, 4101, Australia. s.kisely@uq.edu.au.
authors: Steve
authors: S
authors: Kisely
mesh_terms: D001291:Attitude of Health Personnel; D006282:Health Personnel / Q000523:psychology*; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D001523:Mental Disorders / Q000451:nursing*; D010348:Patient Care Team / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011568:Psychiatric Nursing / Q000592:standards*; D036301:Qualitative Research; D011793:Queensland