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Monday, 23 May 2016

Patient-centred workshop on physical health of people with severe mental illness

West Midlands Academic Health Science Network (WM AHSN) patient-centred workshop: Physical health of people with severe mental illness

By Prof. Carolyn Chew-Graham

Compared to the general population, the life expectancy of people with severe mental illness is reduced by around 15-20 years, with: 
–  a three-times increased risk of premature death 
–  about 75% of deaths being caused by physical disorders 
–  and cardiovascular disease as the single biggest and potentially preventable cause of premature mortality, more common than suicide.

The early phase of psychosis is a critical period for preventing or modifying cardiometabolic risk, avoiding premature death and reducing health inequalities 
–  Weight gain and metabolic disturbance may occur very early in the course of psychosis, accelerating within weeks of treatment initiation 

–  Health risk behaviours including smoking, alcohol and drug misuse, poor nutrition and physical inactivity are common and are powerfully influenced by the social determinants of health.

For this reason, Saeed Farooq and Carolyn Chew-Graham offered a workshop for the AHSN that aimed to highlight the need to manage the physical health of people with severe and enduring mental health problems, explore barriers to implementing the evidence and discuss a programme, which aims to support people with severe mental illness (SMI) make changes to their lifestyle, so reducing risk.

The workshop, held in Birmingham on 6th April 2016, began with Carolyn interviewing David Shiers, a retired GP from Leek, about his experiences in seeking care for his teenage daughter who developed a psychotic illness in her teens. David went on to describe the work he had done with the late Helen Lester, raising the profile of the need to ‘keep the body on mind’. Work done by Carolyn, as ‘Mental Health Champion’ for the Royal College of General Practitioners (RCGP), including the development of ‘fact-sheets’ for practitioners, is included the in RCGP ‘Mental Health Toolkit’.

Saeed presented the evidence for effective interventions aimed at reduced cardiovascular and metabolic risk in people with SMI, which was followed by discussion of why practitioners don’t act. The removal of some of the indicators from Quality and Outcomes Framework (QoF) was debated (Shiers & Chew-Graham 2014; Chew-Graham et al. 2014).

Following a break, featuring rather a lot of cake, which was unfortunate, given the topic, Professors Eleanor Bradley and Veronica Wilkie (Worcester University) presented their work on the ‘SHAPE’ Healthy Living Lifestyle Programme. This innovative programme supports University students to work with people with SMI and facilitate lifestyle and behaviour change around diet, activity, smoking, drugs and alcohol.

Further discussion focussed on the role of the clinician in careful prescribing of antipsychotic drugs (which contribute to cardio-metabolic changes) and monitoring of weight gain, and the respective roles of primary and specialist care.

We concluded the session agreeing that the importance of considering physical health in people with mental health conditions should lead to a slightly changed strap-line of ‘No mental health without physical health’.

Tuesday, 17 May 2016

Professor Elaine Hay awarded Distinguished Member of the British Society for Rheumatology

Congratulations to Professor Elaine Hay, our very own Director of IPCHS on her award of Distinguished Member of the British Society for Rheumatology (BSR). This is bestowed only upon the highest achieving BSR members, who have acted inspirationally throughout their career, advancing knowledge in rheumatology. 
Elaine was the first professor of community rheumatology in the UK and has championed rheumatology services locally, as well as developing research to underpin clinical community rheumatology. To date, she has had an extremely successful research career, currently holding 13 active external research grants totalling £8.4 million in addition to 45 historical grants, which has led to Elaine authoring 24 reviews/editorials and 169 publications.

She has played an active role in BSR committees for over 20 years and has represented musculoskeletal interests on numerous national/ international committees including the NIHR National School for Primary Care, the Department of Health Musculoskeletal Services Strategy Group, the EULAR scientific strategy committee, the Royal College of Physicians Joint Speciality Committee and the NIHR applied research programme grant committee.

Elaine is an inspirational director of IPCHS and motivates researchers and clinicians locally and nationally.

Huge congratulations for this well-deserved award!

Wednesday, 4 May 2016

Finalising the WHO South-East Asia Regional Strategy on Prevention of Suicide

Meeting of Experts

New Delhi, India, 21-22nd April 2016

The above meeting was convened by the World Health Organisation, South-East Asia Regional Office (WHO SEARO) in New Delhi. Experts from Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka and Thailand attended the meeting. Representatives from the country offices of the WHO also attended. 

Among them was Prof Athula Sumathipala, Professor of Psychiatry and the Director, Internationalisation, at the Research Institute for Primary Care & Health Sciences, Keele University and also a Honorary Consultant Psychiatrist, South Staffordshire and Shropshire Healthcare NHS Foundation Trust. Professor Sumathipala is also an Emeritus Professor of Global Mental Health, Kings College London and the Hon Director of the Institute for Research and Development in Sri Lanka.

This meeting signified a positive step in the prevention of suicide in South-East Asia, a region comprising 11 countries and 26% of the global population. Up to 40% of global suicides are reported to occur in South-East Asian countries with 8 countries in particular contributing some of the highest rates of suicide. In South-East Asia the female suicide rate is also high compared to other parts of the world. Previously, Sri Lanka had the highest suicidal rate in the world; annual recorded suicides were close to 50/100,000 population. But since 1997 rates of suicide have decreased due to many significant steps and the determination of the Sri Lankan government. 

The Sri Lankan delegation attending the strategy meeting comprised Dr Neil Fernando (Psychiatrist), Senior Lecturer at the Kothalawela Defence University, Dr De Silava (Public Health Specialist, Director Mental Health Ministry of Health) Dr Sanjiwa Ranaweera (Public Health Specialist), Dr  Sudath Samaraweera (Public Health Specialist, Ministry of Health and Ex-Co member at the Institute for Research and Development in Sri Lanka). Dr Nazneen Anwar, Regional Adviser, Mental Health, WHO Regional Office for South- East Asia, took the leadership in this work.

Dr Samaraweera has an MD from Sri Lanka in which he carried out a psychological autopsy study and a PhD from Kings College London in which he tested a Cognitive Behavioural Therapy outreach approach for people with high risk of suicide. Prof Sumathipala was a co supervisor for both these studies. Both of them have contributed to the limited literature on suicide in Sri Lanka.

If you would like to know more about progress with this important work Prof. Sumathipala would welcome your comments and questions.

[Post written by Athula Sumathipala, Professor of Psychiatry]