- Title
- Addressing the health risk behaviours of people with a mental illness: a collaborative approach?
- Creator
- Bailey, Jacqueline Mary
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Internationally and in Australia, people with a mental illness experience significantly greater morbidity and mortality and reduced life expectancy compared to people without such an illness. The majority of excess mortality is attributable to a higher prevalence of chronic physical disease. The health risk behaviours of tobacco smoking, harmful alcohol consumption, inadequate nutrition and inadequate physical activity are the leading modifiable risk factors for the development of chronic disease. People with a mental illness are consistently reported to experience a higher in engagement in such health risk behaviours than people without a mental illness; however, little research has examined the prevalence of health risk behaviours among people in psychiatric inpatient settings. The provision of preventive care to address such health risk behaviours in mental health services is recommended in policies and guidelines internationally and in Australia. Despite such policies, sub-optimal provision of preventive care has been reported with regards to smoking cessation care, however scant research exists on the extent to which such care is provided for other health risk behaviours. Another potential avenue of health risk behaviour change support for people with a mental illness may be their informal or family carers. Carers have the potential to influence the health risk behaviours of the people they care for with a mental illness, however little is known about carers current: attitudes towards addressing the health risk behaviours for people with a mental illness; provision of health risk behaviour change support, and; potential barriers or supportive strategies to assist health risk behaviour change support. To address these evidence gaps, the aims of this thesis are, to: 1. Examine the need for preventive care for chronic disease risk behaviours in traditional mental health service settings and its current provision. Specifically to: a. Determine the prevalence of health risk behaviours (smoking, harmful alcohol consumption, inadequate nutrition, and inadequate physical activity); interest in improving ‘at risk’ behaviours, and; acceptability of receiving health risk behaviour change support during mental health treatment among a sample of Australian psychiatric inpatients. b. Ascertain the prevalence of preventive care provision to people with a mental illness for the four health risk behaviours in mental health services generally through the conduct of a systematic review. c. Explore family carers’: understanding of relationships between smoking and mental health; views and expectations of smoking bans in specialist mental health treatment settings, and smoking cessation care across a number of service settings. 2. To explore family carer current and potential provision of health risk behaviour change support to people with a mental illness, through: a. Investigating the extent of carers’ current involvement in promoting positive health risk behaviours; carers own health risk behaviours, attitudes and perceptions of their role and ability to address health risk behaviours of the person for whom they provide care. b. Exploring carers’ experiences in addressing the health risk behaviours of the person they care for; existing barriers to addressing such behaviours; and perceptions of potential strategies to assist them to provide health risk behaviour change support. Thesis aims were addressed through the conduct of a series of studies. A cross-sectional survey undertaken with 2075 psychiatric inpatients addressed aim 1a. A systematic review and meta-analysis was conducted to explore aim 1b. A cross-sectional survey of 144 carers of people with a mental illness provided the data utilised in 1c and 2a. Finally, a focus group methodology was employed to explore the experience of 31 carers with regards to addressing the health risk behaviours of the person for whom they provided care (2c). The findings presented in this thesis have contributed to advancing research in the field in a number of ways. Findings further demonstrate the need for mental health services to provide preventive care for health risk behaviours given: the high engagement in risk behaviours and interest in receiving support to change risk behaviours reported among psychiatric inpatients in Chapter 2; the sub-optimal provision of preventive care reported in Chapter 3, and; carers expectations that services accessed by people with a mental illness provide smoking cessation care to their clients with a mental illness identified in Chapter 4. Findings of Chapters 5 and 6 provided the first investigations of the role of family carers in influencing the four health risk behaviours among people with a mental illness and suggest carers have the potential to provide health risk behaviour change support but may be assisted in their role to do so through increased collaboration and communication with services accessed by the person they care for with a mental illness. Overall, this thesis identified the need to explore: how adherence to preventive care policies in mental health services might be increased; how the capacity of family carers to support health risk behaviour change might be facilitated, and; how people with a mental illness themselves perceive health risk behaviour change and what may be helpful in supporting them. The final chapter of this thesis proposes the need for further research to explore such concepts.
- Subject
- public health; mental illness; chronic disease risk behaviours; family caregivers; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1413419
- Identifier
- uon:36626
- Rights
- Copyright 2020 Jacqueline Mary Bailey
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 9 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 640 KB | Adobe Acrobat PDF | View Details Download |