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My Story: Jane, caring for a son with schizophrenia
My Story: Jane, caring for a son with schizophrenia
In our series of videos for Mental Health Month watch this engaging interview with Jane, who cares for her son, diagnosed with schizophrenia.

Watch the video...

Living Well Living Longer

The Living Well, Living Longer program is working to improve overall health in people living with enduring mental illness.

Physical health problems, such as diabetes and heart disease, are common in people living with mental illness. Life expectancy of people with enduring mental illness is up to 25 years less than the general population. These chronic health problems are responsible for most of this early death.

We want mental health consumers to have access to the same high standard of health care as the general population.  We are working with mental health consumers to support healthy lifestyles. All consumers with mental illness are offered metabolic monitoring, using the standard NSW Health Metabolic Monitoring form. Metabolic syndrome is a precursor to cardiovascular disease and diabetes.

There are some resources available to assist with giving patients advice and helping to shape a plan of care.  The observations are basic blood pressure, blood sugar, waist circumference, height and weight.  Review blood results and address readings out range with the treating team, case manager and family so that a follow up plan can be implemented. 

Activities include:

  • Screen and monitor - using the NSW Health metabolic monitoring form and checking pathology blood results
  • Detection - co-morbid physical diagnoses identified and included on discharge summary.
  • Initiation of treatment - medical team, GP, visit to ccCHIP inpatient or outpatient (ambulatory) clinic
  • Ongoing management - psycho-education about diet and exercise
  • Ensure that all clients have a physical health check, see a dentist and have an ECG every 12 months. 

Associated Initiatives:

  • GP Collaborative Care - a joint project with the Inner West Sydney Medicare Local. A new model of care is being trialled, involving an annual health check and care conference with the consumer, care coordinator, and GP present, to establish roles and responsibilities, lines of communication and joint care planning. The aim is to improve physical health care by avoiding gaps and duplication in care between GPs and the Mental Health Services. 

  • ccCHiP Cardiometabolic Clinics - a multidisciplinary clinic with a focus on cardiovascular and metabolic risk factors in people living with enduring mental illness. The clinics are available for inpatients and people living in the community. The clinic involves a psychiatrist, endocrinologist, cardiologist, clinical nurse consultant, dietician and exercise physiologist, who review family history, blood test results, and clinical indicators (e.g. abdominal circumference, oral health etc.). They then recommend changes to management and lifestyle, referring on to further specialist care if required.

  • Specialist care referral - improving access to specialist care such as oral health care, cardiology, and endocrinology specialists. Working relationships with mental health services and other physical health experts. Fast-track referral systems.

  • Health lifestyles - exercise physiologists and dieticians working with mental health consumers to increase their activity and improve healthy eating. Healthy lifestyle activities such community kitchens and gardens, walking groups, sporting clubs and other community-based programs. Supported programs to quit smoking.

  • Education and training - training our workforce to improve the knowledge, skills and confidence of staff and other health practitioners in identifying, treating and managing the health needs of mental health consumers. Continuing Professional Development events for GPs and practice nurses in the district, delivered in collaboration with the Inner West Sydney Medicare Local, focused on the complex physical health needs of mental health consumers.
  • HealthPathways - an online resource providing decision support to GPs who care for a person with mental health problems.

  • GP co-location clinics - for mental health consumers who do not have a nominated GP and find it difficult to access primary care services. These award-winning clinics are in place at Marrickville, Croydon and Redfern Community Health Centres.

Contact Details

ccCHiP Office
t: 02 9767 6027

Ms Angela Meaney - Clinical Nurse Consultant ccCHiP Clinics
m. 0477311758