Background
People living with severe mental illness face increased risk of physical multimorbidity and early death, yet primary care settings - where much of this population receive their care - do not provide adequate physical health support. Here, we evaluate a community-based lifestyle intervention for people living with severe mental illness accessing primary care. The intervention was commissioned by a Primary Health Network and participants were referred through primary care providers. We aimed to determine factors influencing implementation and participant adoption of the intervention, and to assess its effectiveness in improving participants' physical health.
Methods
A prospective mixed methods evaluation was conducted between March 2021 and October 2023 using semi-structured interviews with intervention clinicians, referrers and participants, and pre-post physical activity and dietary outcome measures.
Results
Enhanced accessibility (offering the service in a hybrid format and free of cost) and ensuring the service was multidisciplinary and mental health informed were implementation strategies that alleviated barriers to attendance. Close collaboration with referrers was important for engagement, but making and maintaining contact with general practitioners proved challenging. Low participant uptake highlighted a need for additional engagement efforts. Data suggest the service may improve participants' physical health.
Conclusions
Lifestyle interventions in primary care are feasible to implement and may improve physical health, but additional efforts are needed to improve collaboration with primary care referrers and general practitioners to support with implementation of physical health interventions for people living with severe mental illness.