Metabolic health for health professionals
The Metabolic Health Initiative has been developed to help identify the physical health issues of people accessing mental health care through the creation of a Metabolic Health Action Plan. The plan provides agreed guidelines and referral pathways for people to access appropriate services. The plan also aims to have a consistent methodology of data collection and biomedical monitoring.
In accordance with the Equally Well (PDF 2.5MB) and Royal Australian and New Zealand College of Psychiatrists (RANZCP) (612KB) consensus statements, mental health clinicians in conjunction with GPs are encouraged to ensure people accessing mental health care have a physical health assessment every six months and encourage them to look after their physical health.
Resources below will help you to support your patient.
Metabolic health assessments
The initiative aims for all people accessing mental health care to have a metabolic health assessment which includes:
- review of weight, blood pressure and waist measurement.
- blood tests to monitor cholesterol, blood sugar level, full blood picture and when clinically indicated: Vit D, Vit C, B12, folate, thyroid function, prolactin, liver, and kidney function. Recent research has highlighted the increasing number of people with mental health illness with vitamin deficiencies and endocrine disturbances.1
- an annual ECG is recommended for people taking antipsychotic medication
- regular monitoring
- referral for appropriate interventions as required.
Data on physical health outcomes in mental illness
Overwhelming amounts of evidence highlight the poor physical health outcomes for people with an enduring mental illness.
Australian evidence shows that people living with severe mental illness are:
- likely to die between 14 and 23 years earlier than the general population
- six times more likely to die from cardiovascular disease
- four times more likely to die from respiratory disease
- five times more likely to smoke.2
- around 50% of people with a mental illness have metabolic syndrome.3
- mental health services, that focus on psychiatric symptoms may overlook physical symptoms.4
- there are many factors that contribute to the poor physical health of people with severe mental illness, including lifestyle factors and medication side effects.5
Resources for clinicians
- Australian type 2 diabetes risk assessment tool (AUSDRISK) - available from the Australian Government, Department of Health and Ageing website.
- Australian CVD risk calculator - The AusCVDRisk is a risk assessment, communication and management tool for health professionals.
- Biomedical measurement - things to remember (PDF 119KB)
- Biomedical Monitoring: Clinic protocol and procedure summary (PDF 42KB)
- BMI chart (PDF 152KB)
- HETI Positive Cardiometabolic Health Algorithms – available from the iphYS website.
- Metformin – prescribing in adults guideline (PDF 113KB)
- Psychotropic Induced Constipation Guidelines' (PDF 90KB)
- Supportive biomedical monitoring table (PDF 49KB)
- Tobacco Treatment Framework (PDF 136KB) – provides an intervention framework for people prescribed psychotropic medication.
Resources for people accessing mental health care
People and family/kinship member, carers and or supporter:
- Metabolic health action plan - consumer information sheet (PDF 238KB)
- Being active is a great way to have fun (PDF 323KB)
- Healthy eating can make you feel better (PDF 306KB)
- Quick and healthy snacks (PDF 637KB)
- Everyone needs a GP (PDF 306KB)
-
Psychotropic Induced Constipation Guideline Consumer Sheet (PDF 167KB)
Specific requirements:
- diabetes type 2
- blood pressure
- fats and oils
- cholesterol
- healthy eating tips
- physical activity - it's important
- metabolic syndrome
Waiting room resources
- Metabolic health Everyone needs a GP poster (PDF 1001KB)
- Metabolic health See your GP 6 six months poster (PDF 645KB)
- Metabolic health It's not just about your head TV Screen (JPEG 637KB)
- Metabolic health Everyone needs a GP TV Screen (JPEG 648KB)
References
- Plevin and Galletly, BMC Psychiatry (2020) 20:315
- National Mental Health Commission. Equally Well Consensus Statement: Improving the physical health and wellbeing of people living with mental illness in Australia. Sydney NMHC, 2016
- Professor Brenda Happell CQ University Australia, Researcher focused on increased life expectancy for those with mental illness, 07 October 2011
- Lawrence, Coghlan Health Inequalities and the Health Needs of People with Mental Illness NSW Public Health Bulletin vol.13 No.7 155-158
- David Lawrence1 and Stephen Kisely2 Inequalities in healthcare provision for people with severe mental illness Journal of Psychopharmacology 24 (11) Supplement 4. 61–68
- B Lunnay, P Bywood Co-morbidity of mental and physical illness: Meeting unmet care needs, Research Round up Issue 18 August 2011