Metabolic Health
The Metabolic Health Initiative has been developed to help identify the physical health issues of mental health consumers through the creation of a Metabolic Health Action Plan. The plan provides agreed guidelines and referral pathways for consumers 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 mental health service consumers 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 Mental Health patients 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.
Statistics Show Poor Physical Health Outcomes for People With an Enduring Mental Illness
Overwhelming amounts of evidence highlight the poor physical health outcomes for people with an enduring mental illness. Statistics show that the average life expectancy of someone diagnosed with a mental illness is 50 to 59 years, 20 years less than the general population average.2
The need to ensure a coordinated health care approach for consumers with a mental illness led the Mental Health Directorate (MHD) to develop the Metabolic Health Initiative and Action Plan.
- 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)
- Psychotropic Induced Constipation Guideline Consumer Sheet (PDF 167KB)
- Supportive biomedical monitoring table (PDF 49KB)
- Tobacco Treatment Framework (PDF 136KB) – provides an intervention framework for people prescribed psychotropic medication.
Resources for consumers
Patients and carers:
- Metabolic health action plan - consumer information sheet (PDF 238KB)
- 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)
- 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)
Specific requirements:
- Diabetes Type 2
- Blood Pressure
- Fats and Oils
- Cholesterol
- Health Eating Tips
- Physical Activity - it's important
- Metabolic Syndrome
References
- Plevin and Galletly, BMC Psychiatry (2020) 20:315
- 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