Abstract
Why did you do it? In the aftermath of the Delta & Omicron waves of COVID-19 in Australia, services gradually returned to a ‘business as usual’ model, but it was identified that the pandemic response may have impacted on routine care provision for vulnerable populations.
Who is it for? Individuals with severe mental illness experience disproportionately high rates of chronic disease, leading to a 20-year reduced life expectancy compared to the general population. In 2013, Sydney Local Health District (SLHD) implemented Living Well, Living Longer (LWLL) to address this disparity. LWLL is an integrated care program to improve rates of screening, detection, treatment initiation, and ongoing management of coexisting physical health conditions through a series of care pathways, particularly aimed at individuals receiving ongoing care within the SLHD community mental health service, referred to as "consumers."
Who did you involve and engage with? LWLL employs peer support workers, senior nurses, dietitians, exercise physiologists and smoking cessation support, all of whom play a key role in providing care pathways to consumers. These care pathways include regular metabolic monitoring, a cardiometabolic health assessment tertiary clinic, diet & exercise interventions, and a mental health shared care program that facilitates physical health checks with general practitioners. Additionally, there was close collaboration with the mental health care coordinators and team leaders to promote COVID-19 vaccinations in this community mental health population.
What did you do? Data on COVID-19 vaccination rates was compiled and routinely collected service data was reviewed to identify changes in the rates of metabolic monitoring, mental health shared care, physical health checks with general practitioners, cardiometabolic health clinic assessments, and diet and exercise interventions. The study period spanned from April 2019 to April 2022, allowing for a 12-month pre-pandemic comparison with a two-year peri-pandemic period.
What results did you get? 91.% of consumers received at least two COVID-19 vaccinations, and 61.3% received a booster. However, a 37.3% reduction in metabolic monitoring rates, a 20.1% reduction in Mental Health Shared Care agreements, a 60.6% reduction in physical health checks with general practitioners, a 55.1% reduction in cardiometabolic clinic assessments, and a 19.8% reduction in diet and exercise interventions were observed. Up-to-date data will be presented at the conference to assess whether any signs of recovery are emerging.
What is the learning for the international audience? The COVID-19 pandemic necessitated a comprehensive response from the healthcare system to protect the community. However, the reallocation of resources required for this response came at a cost to routine service provision. While commendable vaccination rates were achieved among mental health consumers in SLHD, there was a significant reduction in other physical health interventions. Mental health providers worldwide should examine local data to determine if similar adverse impacts occurred due to the pandemic.
What are the next steps? It is now crucial to refocus efforts on increasing physical health screening and intervention for individuals living with severe mental illness. Minimising the potential impact of the pandemic on cardiometabolic morbidity and mortality in this population is imperative.