Building Bridges with a Multidisciplinary Lens: The Powerful Phenomena of Physical Activity and Dietary Intervention in Managing Metabolic Disease in Mental Illness.
Devlin Higgins1, Cheryl Lum1, Catherine Finneran 1, Jean Allen 1, Roger Chen 1 1St Vincent’s Health Australia, Sydney, NSW, Australia
Abstract
Introduction
Despite advances in healthcare and research indicating physical-health related mortality and comorbidities are substantially higher across all mental illnesses, traditional segregation of mental and physical healthcare remains high while metabolic mental health (MMH) specific referral pathways remain poor. As such, St Vincent’s Hospital, Sydney (SVHS) has developed a MMH team clinic for inpatient and outpatient settings, comprising an Accredited Exercise Physiologist (AEP), Dietitian, Diabetes Clinical Nurse Consultant, MMH Nurse and Endocrinologist. We have noted marked improvements in cardio-metabolic risk-factors in patients who engaged with the AEP and Dietitian.
Method & Treatment
All patients treated by the SVHS Mental Health service that meet metabolic criteria are flagged by treating teams to be reviewed at inpatient or outpatient MMH clinics. The MMH team review and track anthropometry measures (weight, BMI, waist circumference, blood pressure) and pathology (HbA1c, blood glucose levels, lipid Profile). Tailored physical activity and dietary programs have been pivotal in successful metabolic outcomes.
Results
A 33 year old male admitted for schizophrenia related care had metabolic syndrome, weight 132kg, BMI 43.1kg/m2 and waist-circumference 134cm. Refusing diet and exercise intervention for 2-months, these measures increased to 140kg, 45.7kg/m2 and 144cm. Behaviour change strategies, education, diet and exercise intervention saw these improve to 112kg, 36.5kg/m2 and 114cm over 10 months, demonstrating significantly reduced cardio-metabolic risk.
Conclusion
Collaboration between diabetes and mental health services has been essential in integrating a successful MMH clinic. The clinic has repeatedly demonstrated improved metabolic outcomes when the patient engages with AEP and dietetic services. Early engagement of at-risk patients is essential.
Biography
Devlin is an Accredited Exercise Physiologist and Registered Physiotherapist. His extensive clinical, research and advocacy work allowed him to be awarded Australian Exercise Physiologist of the year (2022) and a national practitioner award in Exercise Physiology. His work in integrating metabolic & mental health care allowed him to be part of the team to be finalist for a St Vincent’s Health Australia Award in 2021 and was part of the COVID virtual hospital team which won the Award in 2022 where Devlin was one of a handful of team-leads.
Currently, Devlin is Exercise Physiology program manager for both The O’Brien Centre for Mental Health Services and The Diabetes Centre at St Vincent’s Health Network, Sydney. He previously held Research Officer (eating disorders) and COVID Healthcare roles.
Devlin’s passion is to improve access to care and physical health pathways for people living with mental illness.