Compared to the general population, people with serious mental illness (SMI) have much poorer physical health, a higher risk of cardiovascular disease and diabetes, and a significantly reduced life expectancy. To put these issues in the spotlight, we organised THINKphysical, the first festival to focus on both mental and physical health issues.
Between 14 and 19 June 2015, Greater Manchester witnessed the bringing together of service users, carers and the general public alongside academic, healthcare and charity bodies in a week-long series of events supported by a number of national and regional organisations.
As is widely reported, the unacceptable health inequalities that people with SMI face are due to many factors, including reduced access to healthcare, the potential side effects of antipsychotic medications and individual lifestyle choices (including higher smoking rates, poorer diets and lower physical activity levels). THINKphysical raised awareness of these issues and highlighted some of the excellent community services already on offer; a sentiment also put forward in Devo Manc’s future health and social care plans, in which integrated care in Greater Manchester will focus more on preventative work in the community, putting strategies in place to keep people well and as independent as possible.
Putting the knowledge of healthcare professionals into the service user and carer sphere is a challenge; THINKphysical was a unique way of doing this, bringing people and organisations together at a number of events to talk frankly, share views and learn from each other. Events ranged from a formal launch at Manchester Town Hall, opportunistic cardiovascular risk checks, bike safety sessions, public lectures, a rounders tournament, art classes, and even flash mob dances across the City. Such was the array of events on offer that there was something to appeal to every taste and pull-in support from all parts of the community.
Flash mobs took place across the City, raising awareness of the Festival and the issues behind it.
The extraordinary levels of support were evident from the outset. In the run-up to the Festival, a workshop involving over 30 stakeholders (made up of service users, carers, mental health professionals, GPs and academics) identified and prioritised the most important areas for future research within the field. Prior to the event, a wider group of stakeholders were asked to submit their key priorities via an online platform. Through a series of group discussions and interactive voting the top three priorities (which centred on the experience of hunger for those on antipsychotics, making choices about medication and education of family and carers) were identified, and work is now underway to establish how best to address them.
Central to the Festival design was a service user and carer group. The group was critical in the creation of three tangible outputs related to the side effects of antipsychotic medication: an overview leaflet, a more detailed leaflet to accompany it and a specially commissioned theatre production called Side Affect. Both leaflets focus on answering questions about medication that service users and carers have historically found difficult to ask, and have been so well received that reprints needed to be ordered mid-festival. Side Affect, a play which is an acute exploration of what it is like to live on antipsychotics, was also put together in consultation with the group. Written and performed by Mad ‘Ed Theatre, all four showings sold out.
As is evident, local engagement was a key priority through all stages of the Festival’s planning and delivery. During all events people were asked to sign-up to register their willingness to be contacted for future research – an invaluable tool for work going forward. In addition to the register, a team of researchers have been talking to (and will continue to talk to) service users, carers and mental health professionals about their experiences of physical healthcare planning in mental health services and how they think that things could be improved. Using focus groups and interviews, the team is exploring physical healthcare planning in detail, and will use people’s feedback to develop a new outcome measure. Once developed, this measure will assess the quality of care delivered to service users from their own perspective.
Over 500 people signed-up for THINKphysical events in what was an incredibly exciting and worthwhile week, but the challenge is to build from here to ensure an improvement in the local understanding, impact and management of physical health for people with SMI.