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Professor Alan Simpson at diabetes and severe mental illness event

Improving self-management of type 2 diabetes for people with severe mental health illness

Knowledge exchange event discusses key issues and identifies priorities for the future

by Professor Alan Simpson

Mental and physical healthcare professionals and service users came to City, University of London in July to hear about the latest findings related to the self-management of type 2 diabetes in people with severe mental health illness (SMI) and to discuss future priorities for research intervention, practice and education.

Hosted by Professor Alan Simpson from the Centre for Mental Health Research, the event presented key results from recent City studies and then invited participants to explore the key issues raised in workshops and to agree priorities for future work.

Opening up the event, Professor Simpson, who is Professor of Collaborative Mental Health Nursing in the School of Health Sciences at City, said:

“At City we are exploring barriers to good mental and physical health, and today we will share some of our findings and hear what you think about what we’ve done so far. We also want to find out where you think we should go next in terms of research, interventions and education.”

Following the introduction to the day, Professor Simpson then spoke about the background to diabetes and SMI. Citing previous research which has shown that there is a 2 to 3 fold increase in the incidence of type 2 diabetes in people with such mental health conditions, Professor Simpson discussed how diabetes can develop due to anti-psychotic medication, and also lifestyle factors such as exercise, diet, as well as smoking.

While lifestyle changes can reduce risk of developing diabetes, it can be hard for people with SMI to make these changes. In addition, care pathways can often be fragmented and complex, and as a result, in people with diabetes and also SMI, life expectancy is lower, so it is important to tackle this issues to reduce such health inequalities.

“The overarching aims and objectives of work our work at City is to improve the delivery of diabetes care for people with SMI, improve the ability of service users  to manage their diabetes and to develop and evaluate interventions to address these inequalities,” said Professor Simpson.

Fellow City researcher Dr Hayley McBain, from the Division of Health Services Research & Management at City, then presented results from two recent studies which interviewed health care professionals and then followed up the initial study with a larger cross national survey. The research found differences in what diabetes care was offered by different professionals, with some less likely to give education and also examine people’s feet, both important parts of diabetes care.

The studies also found there were decreased levels of optimism about the health of patients and their own ability to manage it. This was reinforced by the fact that 57 per cent worried about managing diabetes in people with SMI.

Complimenting this research, Dr Kathleen Mulligan, a fellow researcher in the Division of Health Services Research & Management at City, spoke about recent work looking at identifying barriers and enablers to self-management of diabetes in people with SMI.

Following interviews with service users with diabetes and SMI, it was found that exercise and healthy eating were the most difficult things to manage, with 50 per cent finding it difficult to maintain routine. It was also found that 75 per cent find it difficult to manage their diabetes when their mental health was poor.

Following the introductory sessions, attendees then had the option to go to two of three workshops, which focused on:

  • Interventions for healthcare professionals (Hayley McBain and Chris Flood)
  • Interventions for service users and carers (Julia Jones and Kathleen Mulligan)
  • Implications for clinical practice and professional healthcare education (Alan Simpson and Mark Haddad)

Attendees then voted on the priorities which arose from the workshops, with ‘improved pre- and post-registration education across mental and physical healthcare’, seen as the most important, followed by ‘tailored self-management packages’ for people with SMI and ‘link workers between physical and mental health services’.

Speaking about the day, Professor Alan Simpson said:

“This knowledge exchange event has enabled us to not only share our recent research into diabetes and SMI from both a service user and mental health professional angle, but also hear what people in the health community feel we should focus on next in terms of research, interventions and education. The discussions and workshops have been incredibly valuable and the results will help us achieve our aim of improving the delivery of diabetes care for people with SMI.”

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