Acceptability and Receipt of Preventive Care for Chronic-Disease Health Risk Behaviors Reported by Clients of Community Mental Health Services.
OBJECTIVE
Compared with the general population, people with a mental illness have a greater prevalence of behaviors that contribute to higher chronic disease rates. Mental health clinical guidelines recommend preventive care to address such behaviors; however, little information is available about whether clients consider preventive care acceptable or about the prevalence of such care in mental health services. This article describes acceptability and receipt of assessment, advice, and referral for smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and physical inactivity, as reported by community mental health service clients. The association between preventive care, diagnosis, and number of clinical appointments was examined.


METHODS
A cross-sectional telephone interview was conducted with clients (N=558) of community mental health services in Australia.


RESULTS
Although preventive care was highly acceptable to clients (86%-97%), receipt of preventive care was low. Client receipt of risk assessment ranged from 26% (assessment of fruit or vegetable intake) to 76% (assessment of alcohol consumption). The proportion of clients at risk of and assessed for unhealthy behavior who then received brief advice ranged from 69% (fruit or vegetable intake) to 85% (physical activity), whereas only 38% (alcohol consumption) to 49% (smoking) received any referral. A greater number of mental health appointments were associated with higher prevalence of preventive care, as were diagnoses of diabetes or respiratory conditions and not having a schizophrenia diagnosis.


CONCLUSIONS
Practice change strategies are required to increase the delivery of routine preventive care within mental health services if clients are to benefit from clinical guidelines.
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Kate
K
Bartlem
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Jenny
J
Bowman
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Megan
M
Freund
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Paula
P
Wye
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Christophe
C
Lecathelinais
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Kathleen
K
McElwaine
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Luke
L
Wolfenden
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
Karen
K
Gillham
Ms. Bartlem, Dr. Bowman, and Dr. Wye are with the School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: kate.bartlem@hnehealth.nsw.gov.au ). Ms. Bartlem and Dr. Wye are also with the Department of Population Health, Hunter New England Local Health District, Wallsend, New South Wales, where Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, Ms. Gillham, and Dr. Wiggers are affiliated. Dr. Freund, Mr. Lecathelinais, Ms. McElwaine, Dr. Wolfenden, and Dr. Wiggers are also with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales. All authors are members of the Hunter Medical Research Institute, New Lambton Heights, New South Wales.
John
J
Wiggers
D000328:Adult; D019973:Alcohol-Related Disorders / Q000517:prevention & control; D001315:Australia; D002908:Chronic Disease; D003156:Community Mental Health Services / Q000379:methods*; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011314:Preventive Health Services / Q000379:methods*; D012017:Referral and Consultation; D018570:Risk Assessment; D012309:Risk-Taking; D057185:Sedentary Behavior; D000074606:Smoking Prevention