2010 Award Winner

Tips and Tricks to Improve your Metabolic Health

Category - Improving Patient/Resident Centredness

The Problem

Metabolic syndrome is the name for a group of risk factors that are linked to obesity. These risk factors increase the risk for heart disease and other health problems, such as diabetes and stroke. Research has shown that people with psychiatric illness are at far higher risk than the general population for developing metabolic imbalance and ultimately Metabolic Syndrome. The reasons for this include medications – which can cause significant weight gain – as well as sedentary lifestyle, poor diet, smoking habits, poverty, living conditions, co-morbid addictions, and lack of comprehensive medical care.

The Innovation

Clinicians at the Mental Health Centre in Penetanguishene had become increasingly concerned about prescribing psychotropic medication to clients who because of poverty and/or poor lifestyle choices were often already morbidly obese or suffering from diabetes, pre-diabetes, high lipid levels and hypertension. They decided to develop a program to address these concerns, and undertook a comprehensive literature search to study other organisations that were establishing similar programs. They developed a work plan and created an inter-professional team composed of a psychiatrist, three registered nurses, a registered dietician, a therapeutic recreationist, an addictions counsellor, an occupational therapist, a chaplain, a social worker, an aesthetician, and a peer support worker. They also developed a series of best practice education modules. The first series of modules commenced in September 2009.

The Results

The Mental Health Centre is reporting increased clinical monitoring of clients who are prescribed psychotropic medications, in addition to a greater general awareness of the existence of Metabolic Syndrome as a serious illness in clients suffering from mental illness. There is also increased collaboration between hospital programs and departments to mitigate the risks associated with mental illness and its treatment. The rate of client referral to the program is progressively rising as word of its success spreads.

Next Steps

As this project moves forward, mandatory referral to the clinic may be implemented for all clients prescribed novel antipsychotics. In addition, research in this area is being stepped up, with an eye to expanding the program and adjusting it to fit different patient populations.