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Physical Health Supports for Mental Health Services

Physical health disparities exist across the spectrum of mental illnesses. Rates of physical co-morbidities are also high in people with mental illness which can result in a reduction of life expectancy. People with serious mental illness die 10-20 years younger than the general population; they are four times more likely to die from a respiratory disease and almost three times as likely to die of a cardiovascular disease.  Higher levels of mortality and morbidity occur due to increased lifestyle risk factors such as sedentary behaviours, poor diet, smoking, and alcohol abuse. Another contributing factor may be the prescription of anti-psychotic medication with rates of metabolic syndrome reported at 32% with those with psychoses and up to 60% for those with a longer duration of illness. The mental health services have developed a number of supports to address physical health disparities. These initiatives were co-produced through valuable input from service users. 

LET’S GET ACTIVE to improve Health and Wellbeing: Guidelines to support Mental Health Service Users to engage in Physical Activity:

Physical activity has a significant number of benefits for people with mental health problems. It is important that we encourage all service users to be active if it is clinically safe to do so.

To assist with this Mental Health Services in partnership with Health and Wellbeing have developed guidelines to: 

Support staff to promote awareness of the benefits of physical activity as a powerful therapeutic tool for people with mental health difficulties.
Provide practical resources and strategies for staff to support service users to incorporate meaningful physical activity into their daily life. 
The guidelines outlines the benefits of physical activity, provide tip on how staff can support service users to get more active and gives working examples for increasing physical activity within mental health services. This document has been jointly developed by HSE – Mental Health Services and the HSE Healthy Eating Active Living Programme and had a multidisciplinary steering group.

Physical Health Assessment form for Acute Adult Services incorporating Making Every Contact Count (MECC) Assessment:

This form contains a number of sections. The first section is the Medical Assessment (including physiological observations filled in by nursing staff or admitting doctor and physical assessment to be completed by the admitting doctor or an Advanced Nurse Practitioner (ANP) qualified to do so). The second part is the Lifestyle Assessment including attendance to GP, Dental, Optician and National Screening Programmes, sleep assessment and health behaviours. The mental health services have included the MECC recording tool in the assessment to meet with the National HSE MECC Programme and to reduce duplication on form filling for staff. Mental health services have developed referral pathways to assist staff to fill in the Lifestyle Assessment. The physical health assessment form and referral pathways were developed by a multidisciplinary group and piloted using a PDSA approach in three acute adult units. 

Please find links below to these referral pathways:

Mental Health Nutrition Folder

Diet and good nutrition are important at all stages of life. They are an integral part of ensuring a balanced mood and promoting a feeling of wellbeing amongst service users in mental health.

The dietician provides advice on a wide range of nutrition issues for mental health service users including those who live in long-stay residential units. Implementation of this dietary advice in these units is dependent on the support of catering staff, care staff and nursing staff.

This nutrition resource has been developed to provide information and support for those staff. It combines basic nutrition information on a range of common nutrition topics with concise practical advice that will be useful for all involved in the care of the service user.

Read the Mental Health Nutrition Folder.

Irish National Early Warning System (NEWS)

How to complete the NEWS observation chart

Presentation to provide information about how to use NEWS for staff in acute settings

Patient observation chart

Making Every Contact Count: MECC
Healthy Ireland https://www.gov.ie/en/campaigns/healthy-ireland/
Tobacco: https://www.hse.ie/eng/about/who/tobaccocontrol/
Alcohol: https://www.askaboutalcohol.ie/
Healthy Eating Active Living HEAL: https://www.hse.ie/healthwellbeing/heal
Mental Health Commission publications on Physical Health Mental Health Commission