Recent policies and guidelines are attempting to highlight the significant physical health care needs of people with severe mental illness (De Hert et al. 2009, Royal College of Psychiatrists, 2009). A core mental health policy document in Ireland ”A vision for change” (2006) highlighted the recovery paradigm, which requires a shift from seeking a cure at the hands of professionals to taking responsibility for one’s own care and growth. Clearly,
management of physical health fits well into the recovery paradigm. In this report, however, there were broad statements referring to physical health but there was no evidence referring to how best to manage or intervene to improve physical health. It would seem timely to action these concerns about the physical health of people with schizophrenia and collate available evidence to support this health policy document.
Methods to improve physical health can be considered on a continuum from brief once-off physical health advice to structured targeted interventions. There is a growing body of literature in the broad area of physical health in schizophrenia, which appears to show some efficacy, yet the totality of evidence from related systematic reviews has never been assembled before into one coherent document in a systematic way. A recently published
Cochrane review (Tosh et al. 2014) has suggested that physical healthcare advice does not have a powerful effect on physical health. This naturally leads to the question of what, if any, strategies work to improve physical health of this population, and which require further evaluation.
As evidence of methods to improve physical health care of people with schizophrenia is disparate, an overview will be conducted at the macro-level which will leverage and bridge the gap from previous work connecting outcomes data in this area to provide new insights and will explore these broad questions;
1. How best should we intervene to improve physical health in people with schizophrenia?
2. How effective are these methods?
3. What are the gaps in the literature and avenues for future research?
In the proposed overview as per Tosh 2014 in a related Cochrane review, on physical health in people with schizophrenia, we will define ‘physical health’ as ‘soundness of body’ as opposed to the WHO’s definition of ‘health’ which includes mental and social well-being (WHO 1948).
Overall aim:
To summarise evidence from trials, Cochrane reviews and non-Cochrane systematic reviews of methods used to improve physical health in people with schizophrenia and their efficacy and effectiveness by performing a full upto- date Cochrane overview.
Specific Objectives:
1. To broadly identify all relevant trials, Cochrane reviews and non-Cochrane systematic reviews
2. To survey identified evaluative research to produce a ‘birds eye’ view of what is done and not done
3. To extract all relevant quantitative and qualitative data
4. Informed by output of Objectives 2 and 3 to produce at least one Cochrane review, a paper publication
and an overview of methods to improve physical health in people with schizophrenia
5. To actively engage with policy makers and key stakeholders to tailor evidence to clinical, research and
public needs
6. To disseminate outputs widely using social media and other channels.
