NSUN network for mental health is an independent, service-user-led charity that connects people with experience of mental health issues to give us a stronger voice in shaping policy and services.

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Healthy Lives

Healthy Lives Project

Improving physical health services for people diagnosed with serious mental illnesses

This is a user-led study which the Healthy London Partnership mental health programme commissioned NSUN to undertake.

We asked:

  • What physical healthcare experiences do people with serious (enduring) mental illness diagnoses have?
  • What are their needs?
  • What improvements in commissioning and in services are needed?

We recruited as widely as possible within London to make sure that the views of people from a diverse range of communities were obtained. During the first part of the study, two surveys were conducted, one with people who have lived experience of a serious mental illness diagnosis and a second with unpaid carers/family members of people who have this diagnosis. The surveys were followed up by two workshop days, attended by people with lived experience, unpaid carers/family members and professionals with non-clinical backgrounds.

Not surprisingly, given that this was a user-led study, some findings were different from those emerging from projects led by researchers without lived experience. The findings also imply a need for some fundamental changes in physical healthcare commissioning and physical healthcare services. Survey participants and workshop members were concerned to have good physical healthcare. They also put a particular emphasis on having a wide range of models and services rather than medical model approaches being dominant. They underlined the importance of taking the whole of people’s lives into account and of suiting services to people from diverse and disadvantaged community groups as well. They stressed the need for warm, human, positive and creative qualities.  They also gave priority to partnership working by professionals and to opportunities for involvement in services and commissioning at all levels.

Their particular recommendations for the commissioning and provision of services in London were as follows:

Recommendations

1. Medical model usage

Move away from a dominant medical model approach in mental health and physical health services

2. A fully holistic approach

2.1 Take full account of the impact which lived experience of serious mental health problems/mental distress can have on people’s ability to look after their physical health, whilst also acknowledging steps which people with serious mental illness diagnoses take to self-manage

2. 2 Provide more information for service users about the impact of psychiatric medication, address its physical side effects more fully and make sure  that  a wider range of alternatives is available  

2.3 Give increased priority to whole life approaches in physical health provision which cover mental wellbeing, physical health, personal life circumstances, socio-economic environments, social status and spiritual beliefs and do so through a range of resources, not just clinical provision

2.4 Build on the sorts of whole life examples which project participants have identified as helpful to people with lived experience

2.5 Put a particular emphasis on the commissioning and provision of community settings and community-based resources for physical healthcare: community centres, community-led groups, charities and user-run agencies as well as public health facilities, GP surgeries and other community-based medical facilities

3. Information and access

3.1 Make sure that information about holistic resources for physical healthcare and support with accessing them are available in a variety of settings for people with lived experience, including those who are on low incomes

3.2 Be aware of the value which people with lived experience put on personal contact, but also use internet resources and information technology such as text messages to update people with lived experience where they find the latter helpful

4. Integrated support and partnership working

4.1 Ensure better information-sharing between healthcare professionals where people with lived experience have agreed to the passing on of personal information

4.2 Significantly improve the co-ordination of care between physical and mental healthcare professionals and  between them and other professionals, for example those working in social services and in housing

4.3 In the provision of physical health services, promote much stronger partnerships between healthcare professionals and workers in community-led resources, charities, advocacy services and user-run groups

5. Equal opportunities

5.1 Make sure that physical health services are respectful of and tailored to people’s lived experience and to factors such as age, ethnicity, gender, sexual orientation and/or additional disabilities

5.2 Specifically address physical health issues for those who may face additional disadvantages, including  members of BAME communities, women, people who identify as LGB, or other and older people, for example their experiences of and models for mental health problems, their life circumstances and their access to physical health resources which are relevant to them 

6. Settings and approaches

6.1 Make physical healthcare settings welcoming and inviting

6.2 Recognise the extent to which people subjected to detention under the Mental Health Act 2007 can feel disempowered and distrustful of professionals and work hard to establish empowering and positive relationships with them

6.3 Put a greater focus on listening skills, empathy, fun and creative approaches, strengths-based models and a note of moving towards good things rather than avoiding physical health risks

7. Training

7.1 Provide more input  for health professionals in mental and physical health services which people with lived experience find meet their needs

7.2 Offer people with lived experience opportunities to supply training for healthcare professionals in the physical and mental healthcare models, approaches and interventions which they find valuable

8. Research

8.1 Promote research funding for physical health and physical wellbeing options which are important to people with lived experience

8.2 Give weight to qualitative as well as quantitative research when reaching decisions about which physical health services to commission and provide

9. Influence and involvement

9.1 Make sure that people with lived experience can have a real and increased influence at personal, service provision and commissioning levels,  for example through further self-management opportunities, organisational uptake of the 4Pi National Involvement Standards and  the use of values-based commissioning

9.2 Provide for training which equips people with lived experience to have the voices they want about helpful physical healthcare commissioning and provision

9.3 Pay increased regard as well to the valuable roles which family members, friends and peers can play in supporting people with lived experience to address their physical health needs and to have an influence in the commissioning and provision of these

9.4 Act on changes in the commissioning and provision of physical health services which people with lived experience want.

Download the reports below

Healthy Lives Project Full Report 2017
Health Lives Project Executive Summary 2017