“They are also more likely to have limited income, transport and support, so health and community services need to be more supportive, coordinated and perhaps more creative in how treatment is provided.” Over the next two years, Queensland’s public mental health services will implement local solutions to improve the routine screening, detection and management of physical health concerns in people with serious mental health illness, initially focusing on those diagnosed with schizophrenia. The MHCC will support local services by providing regular feedback on progress that includes state-wide benchmarking and hosting six-monthly forums to showcase local innovation, review best practice and support open discussion around progress and challenges. Welcoming the initiative, Trish Roderick, who heads up Diabetes Queensland’s health team, said placing physical health, including heightened awareness of diabetes, at the forefront of mental health services was a positive step. “Diabetes Queensland has been working with Metro South Addiction and Mental Health Services to ensure mental health professionals have the best information available to them to help improve the quality of life of people with severe mental illness,” Ms Roderick said. “We are also currently exploring the possibility of providing targeted information days for mental health consumers with diabetes and their carers.” For more, visit http://www. activatemindandbody.com.au/ or contact
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In response, Queensland Health mental health clinicians have recently elected to target the screening, detection and management of co-morbid physical health conditions, including diabetes, for people with severe mental illness across adult mental health services. As part of a state-wide rollout, the Mental Health Clinical Collaborative (MHCC) initiative will bring clinicians from services across the state together to work on improving the routine physical health assessment of people with an enduring psychotic illness. This will involve metabolic monitoring as the starting point for routine physical health assessment, screenings of weight, height, waist circumference, BMI, blood glucose levels and cholesterol levels every six months MHCC Chair Dr Brett Emmerson said the decision to target physical health as a priority issue was timely, reflecting clear evidence that identified disproportionately adverse health outcomes among people with a serious mental illness when compared to the general population. Dr Emmerson added that prevention measures for type 2 diabetes and steps to improve wider physical and oral health of people in our mental health community is a shared responsibility of public mental health services and other providers, such as general practitioners. “We need to better inform consumers and their carers of our services about the issues surrounding their physical and oral health so they can be more proactive in their health and recovery, and start intervention early,” he said. “People with severe mental illness already have to deal with a range of mental health and possibly cognitive difficulties associated with their illness – take for example, poor memory, attention and motivation.
Donna.Carmichael@health.qld.gov.au n Donna Carmichael works with Queensland Health as Service Integration Co-ordinator with Metro South Addiction and Mental Health Services.
Teresa’s story My name’s Teresa. I’m 44 and recently found out that I have type 2 diabetes. I remember feeling unwell at home and called an ambulance. I was taken to hospital and found to have a blood glucose level (BGL) reading of 21. I spent a week in hospital. When I was discharged, I went to see my doctor who told me I had type 2 diabetes. I don’t recall having ever been screened for diabetes before this. I also had no idea that I could be at risk of developing diabetes and knew very little about the condition. My father had type 2 diabetes but he died some years ago. I don’t remember how he was treated apart from being on a special diet.
My doctor prescribed Diabex, which I take reasonably regularly, although my concentration is not always great and sometimes I forget. A nurse showed me how to test my BGLs, which I do every second day and I also saw a dietitian for a couple of sessions. It’s been more than 15 years since I was diagnosed with schizophrenia. I was working at the meatworks in Oxley and started feeling unwell and not thinking straight. I was hospitalised for a short time. I have been taking Risperdal (Risperidone) tablets since I was diagnosed and visit a mental health service from time to time. I receive good support from my doctor and case manager. I’ve lost 17kg over the past couple of years. I now weigh 88kg. I need to lose more. I try to
walk regularly, but experience fatigue and I sleep more than most people I know. Exercise can be a challenge. I’d like to receive more support when it comes to my physical health to help me lose the extra weight and to improve my overall fitness. n Teresa’s case manager reports that over the past two years Teresa has reported a variety of physical symptoms including dizziness, racing heart and generally feeling unwell. At times, her case manager says it has been difficult to work out if the symptoms stem from stress, anxiety or deterioration in her mental state. It is now apparent that Teresa has a number of underlying physical health issues – including diabetes-related complications.
Diabetes Network – Summer 2013/14
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