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Active steps towards a healthier life for people with severe mental illness: a qualitative approach to understanding the potential for implementing change

Year: 2013

Type: article

Abstract: Objective. Our health systems are failing to provide optimal physical care for people with severe mental illness. To address this gap, Queensland Health and General Practice Queensland in partnership developed a comprehensive package of guidelines and health messages. However, guidelines alone are likely to be inadequate motivators of change. The objective of this research was to qualitatively explore key stakeholders’ expectations about the implementation of guidelines, with the purpose of identifying potential interventions to support practice change. Method. Participants were recruited from the partnership governance committee. A semistructured interview guide was used to gather data. Using grounded-theory techniques, the data were analysed to identify key themes. Results. All stakeholders agreed that the purpose of developing comprehensive guidelines and health messages was to achieve change through innovation and the promotion of early intervention, reduction of avoidable admissions and sectoral integration. However, existing structures within the system were considered to be insurmountable barriers. Conclusion. Key stakeholders sought broader change than just guidelines and health messages developed by the partnership focussed specifically on awareness-raising about the physical care of people with severe mental illness. However, there was no clear consensus as to what that change should be. This mismatch between the goals and actions of such a large-scale initiative is problematic. Suggestions are made about how to address change. What is known about the topic? The physical and oral health of people with severe mental illness is poor. One response that is frequently used to improve the health of this population is to develop and implement guidelines for practice. However, oral healthcare is frequently omitted from guidelines for care. Moreover, guidelines are not always adopted in everyday practice. What does this paper add? This paper outlines a process of guideline development and includes investigation of the short- and long-term goals that a governing committee held for the implementation of guidelines for both the physical and oral healthcare of people with severe mental illness. Additionally, we explore gaps between a short-term focus for guideline implementation and the longer-term goals of achieving improved healthcare. What are the implications for practitioners? Cultural change is required if the physical and oral health of people with severe mental illness is to be improved. However, a mismatch between the goals and actions of large-scale initiatives is problematic. Thus, clearly identified avenues for realising long-term culture change are required if new practices are to be embedded in everyday routines. -->

Source: Australian Health Review

DOI: 10.1071/ah13062

Authors: Carolyn Ehrlich, Steve Kisely, Elizabeth Kendall, David Crompton, Elizabeth Crowe, Ann Maree Liddy

Institutions: Griffith University, The University of Queensland, Metro South Health

Language: English

Topic: Health Policy Implementation Science

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: Queensland Health, Australian Government, Australian Research Council