Angela Douglas

Consensus statement on the role of Accredited Exercise Physiologists within the treatment of mental disorders: a guide for mental health professionals.

Objective: The aim is to identify the role and scope of Accredited Exercise Physiologist (AEP) services in the mental health sector and to provide insight as to how AEPs can contribute to the multidisciplinary mental health team. Methods: A modified Delphi approach was utilised. Thirteen AEPs with experience in mental health contributed to the iterative development of a national consensus statement. Six mental health professionals with expertise in psychiatry, mental health nursing, general practice and mental health research participated in the review process. Reviewers were provided with a template to systematically provide feedback on the language, content, structure and relevance to their professional group. Results: This consensus statement outlines how AEPs can contribute to the multidisciplinary mental health team, the aims and scope of AEP-led interventions in mental health services and examples of such interventions, the range of physical and mental health outcomes possible through AEP-led interventions and common referral pathways to community AEP services. Outcome: AEPs can play a key role in the treatment of individuals experiencing mental illness. The diversity of AEP interventions allows for a holistic approach to care, enhancing both physical and mental health outcomes.

Active engagement of consumers in a healthy lifestyle program: outcomes of a multidisciplinary pilot project in a mental health rehabilitation unit

Paper abstract: Australian College of Mental Health Nurses 40th International Mental Health Nursing Conference Honouring the Past, Shaping the Future, 7-9 October 2014, Melbourne, Vic Australia. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Douglas, A., Patterson, C., Watson, S., Gruber, E. & Gagan, A. (2014). Active engagement of consumers in a healthy lifestyle program: outcomes of a multidisciplinary pilot project in a mental health rehabilitation unit. International Journal of Mental Health Nursing, 23 (Suppl. 1), 9-9. This journal article is available at Research Online: http://ro.uow.edu.au/smhpapers/2282 ACTIVE ENGAGEMENT OF CONSUMERS IN A HEALTHY LIFESTYLE PROGRAM: OUTCOMES OF A MULTIDISCIPLINARY PILOT PROJECT IN A MENTAL HEALTH REHABILITATION UNIT Angela Douglas , Christopher Patterson , Elise Gruber , Sarah Watson 2b and Alex Gagan 2b Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia; 2 Illawarra Shoalhaven Local Health District, NSW Australia ( The Wollongong Hospital, b Shellharbour Mental Health Rehabilitation Unit) The National Mental Health Commission identifies the physical health of those living with a mental illness as worse than the general community on just about every measure. This paper presents the results of a pilot healthy lifestyle program aimed at engaging consumers with targeted and individualised health activities within a recovery-orientated rehabilitation unit. The ACTive program ran for 18 weeks in 2013, delivered by a team of mental health staff, dietitian, exercise physiologist, academic, and nursing and allied health students. Approval to evaluate the program was received through the Joint UOW/ISLHD Health and Medical HREC. Evaluation targeted quantitative physical health measures for consumers, and qualitative measures for consumers, staff and students. Preliminary results show a grouped average weight loss of 1.1kg, which has clinical significance given the weight-gain challenges associated with serious mental illness. Statistical comparison with a control group is currently underway. Consumers also improved in functional exercise capacity, with 80-metre average increase for the 6-Minute Walk Test, and 2.6 repetition increase in the Sit-to-Stand test for functional leg strength. Feedback provided has identified a number of key challenges to the sustainability and management of this type of program within current mental health service provision environments. Targeted and individualised health programs integrated into mental health services have great potential to reduce the existing disparity in physical health. However, the capacity for collaborative involvement of multidisciplinary health professionals is critical. Furthermore, programs that foster allied health student placement may enhance vocational scope for allied health within mental health services.

Graduate destinations: where do our graduates go and how can we improve their journey?

This study aimed to determine the career and study paths that University of Wollongong (UOW) graduates take once they complete their qualifications in either nutrition, dietetics, exercise science or exercise physiology and to establish how prepared they and their employers felt they were. Three online surveys (December 2012 graduates, July 2007-July 2012 graduates and employers) were conducted via Survey Monkey® in late 2012 that asked about work and study experiences pre and post-graduation, strengths and weaknesses of programs, ideas for further curriculum development and experiences employing UOW graduates. 23 responses were received from the December graduating students, 96 from earlier graduates and 11 from employers.The Australasian Nutrition Care Day Survey (ANCDS) reported two-in-five patients in Australian and New Zealand hospitals consume ≤50% of the offered food. The ANCDS found a significant association between poor food intake and increased in-hospital mortality after controlling for confounders (nutritional status, age, disease type and severity)1. Evidence for the effectiveness of medical nutrition therapy (MNT) in hospital patients eating poorly is lacking. An exploratory study was conducted in respiratory, neurology and orthopaedic wards of an Australian hospital. At baseline, 24-hour food intake (0%, 25%, 50%, 75%, 100% of offered meals) was evaluated for patients hospitalised for ≥2 days and not under dietetic review. Patients consuming ≤50% of offered meals due to nutrition-impact symptoms were referred to ward dietitians for MNT with food intake re-evaluated on day-7. 184 patients were observed over four weeks. Sixty-two patients (34%) consumed ≤50% of the offered meals. Simple interventions (feeding/menu assistance, diet texture modifications) improved intake to ≥75% in 30 patients who did not require further MNT. Of the 32 patients referred for MNT, baseline and day-7 data were available for 20 patients (68±17years, 65% females, BMI: 22±5kg/m2, median energy, protein intake: 2250kJ, 25g respectively). On day-7, 17 participants (85%) demonstrated significantly higher consumption (4300kJ, 53g; p<0.01). Three participants demonstrated no improvement due to ongoing nutrition-impact symptoms. “Percentage food intake” was a quick tool to identify patients in whom simple interventions could enhance intake. MNT was associated with improved dietary intake in hospital patients. Further research is needed to establish a causal relationship.

Facilitating better health care for mental health consumers: complexities of establishing a partnership program

Abstract of paper that presented at the Australian College of Mental Health Nursing 39th International Mental Health Nursing Conference, 22-24 October, 2013, Perth, Australia.Climate change is causing more frequent and severe adverse weather events that impact large numbers of people and leave a path of destruction leading to long-term consequences. Psychosocial distress including symptoms such as anxiety, sleep disruption, recurring intrusive thoughts of the events and mood changes may affect survivors even though they may not have experienced any form of physical harm (Simpson et al., 2011). The link between extreme weather events such as floods, cyclones and hurricanes resulting from climate change, and psychosocial distress is well established (Friedman & McEwen, 2004; Reser et al., 2011; Sattler et al. 1995; Sattler et al., 2002; Salcioglu et al., 2007; Simpson et al., 2011). Tropical cyclone (TC) Yasi struck North Queensland on Thursday February 3, 2011 between midnight and 1am and made landfall on the southern tropical coast near Mission Beach. The cyclone wreaked havoc across the region; never before has a cyclone of that intensity crossed the coast of North Queensland. A survey of community members, undertaken with assistance from local community organisations, collected data using an electronic and paper based questionnaire. The results indicate those with signs of psychosocial distress were more likely to be older (60.6%) and reside in the area worst affected by the cyclone, were more likely to have been without essential services for an extended period of time, more likely to have inadequate levels of insurance, and more likely to have had experienced moderate or major loss of sentimental possessions, money for living expenses and personal transportation. Community support is one of the major factors in community resilience. Therefore, working with the community to help members better understand the level of current distress is important for the development of response interventions. Feedback to the community thus formed a pivotal component of the study.engage or disengage from the early intervention service. OUTCOMES AND PRACTICE CHANGE Clinicians can have an increased awareness of what influences levels of engagement and this will allow for appropriate changes to be made to individual practice and services in order to enhance engagement for this population. LEARNING OBJECTIVES 1. To understand the impact of disengagement from early intervention services. 2. To hear young people’s stories of engagement and reflect on one’s own clinical engagement with consumers. 3. To understand the factors influencing engagement or disengagement from community mental health teams.