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Improving the physical health of people with severe mental illness: Boundaries of care provision
Author(s) -
Ehrlich Carolyn,
Kendall Elizabeth,
Frey Nicolette,
Kisely Steve,
Crowe Elizabeth,
Crompton David
Publication year - 2014
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12050
Subject(s) - mental health , workforce , health promotion , nursing , health care , mental illness , promotion (chess) , evidence based practice , population , psychology , medicine , public health , psychiatry , environmental health , alternative medicine , political science , pathology , politics , law
There is compelling evidence that the physical health of people with severe mental illness is poor. Health‐promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence‐based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Q ueensland, A ustralia. Fifty participants were interviewed. The core theme that emerged from the data was that of ‘care boundaries’ that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health‐care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health‐promotion practice. Thus, the implementation of evidence‐based guidelines depended heavily on the capability of the workforce to develop and adopt boundary‐mediating strategies.