Mental health nurses 'set bad example to patients'
 

Poor physical health is rife among people with severe mental illness in the UK, a study shows.

The study leader said mental health nurses might be partly to blame for setting a bad example.

High levels of obesity, heart disease and diabetes were found among 782 patients with conditions such as schizophrenia and bipolar disorder.
The University of East Anglia study suggests this is why their life expectancy is much reduced.

Some studies suggest the life expectancy of people with severe mental illness is as much as 25 years shorter than that of the general population.
The latest work, published in BMC Psychiatry, adds to evidence that physical health, not mental health issues, such as suicide, are primarily to blame.

It found that inactivity, poor diet, smoking and excessive alcohol consumption were the norm.

A high number of the participants were being prescribed drugs known as atypical antipsychotic drugs, which are associated with weight gain.
Lead researcher Professor Richard Gray, of UEA's School of Nursing and Midwifery, said: "Mental health nurses do a tough job and are compassionate and highly committed.

"But they do not tend to be skilled at managing the physical health of their patients."

Bad example

Professor Gray said that many mental health nurses often did not follow a healthy lifestyle themselves.

His previous research has showed that mental health workers have a higher rate of smoking than the general population.

He suggested that their bad habits might rub off.

"Since mental health workers tend to have sustained one-to-one relationships with their patients over many years, those who smoke, have a poor diet and fail to take regular exercise are having a negative influence on the lives of already vulnerable people.

"We urgently need to train our mental health workers to lead by example and intervene if their patients' physical health is deteriorating.
"All health professionals have a duty to promote health in the patients they treat.

"Government guidelines must reflect the shared responsibility all health care professionals have to promote health in one of the most marginalized and socially excluded groups in our society."

Dr Peter Carter, Chief Executive and General Secretary of the Royal College of Nursing, said: "Mental health nurses will recognise that too often, patients can suffer twice over because of a combination of poor mental and physical health.

"There are some complex reasons behind this, such as the side effects of prescription drugs, lifestyle limitations and social and economic problems.
"However, we also know that there are some excellent nurse led initiatives which can really make a difference to people.

"It takes a concerted effort not just among different parts of the health service but with other professions to turn this situation around."

http://www.bbc.co.uk/news/health-12732954

Thats the equivalent of saying that primary school teachers shouldnt eat crisps for lunch because its a bad example for pupils.

I dont know what to think of this.

Lol <<< That is my initial reaction.

I'd say the biggest contributing factor for obesity in patients with psychotic illnesses is the prescription of antipsychotic medication by a long shot! I gained a ton of weight on it, even visiting the gym twice a week, going for regular walks, and cutting down on food didn't stop me piling it on.

All this talk about mental health workers not leading by example seems like a cop out to get the drugs companies off the hook to me.

Funnily enough since I dumped the meds, the weight has come straight off and I'm now back to a decent weight whereby clothes actually fit me again.

Yes alot of MHN's Ive come across do smoke.
They do a damn well stressful job, and after someones just been kicking off in their face about how their going to "do them in" it does help to have a cigarette.
It doesnt mean they promote it, it just means they do the same activity that alot of people who are under alot of stress do.
ARGH. Im not awake enough to explain my point properly, but these people who criticise can damn well do my job, and every other MHN's job before they can criticise.

I would think that persons with MH conditions need additional persons on their team. I used to participate in regular exercise as part of the relationship with my support worker. There are also dieticians and trainers that can provide help. Maybe a MH day centre should have walking or cycling clubs for persons with MH issues.

One of the issues may be once you get past the meds, sessions and general maintenance- as in are they bathing, etc. maybe no one is thinking about managing that persons general health...........but it doesn't sound right. Don't nurses have to do general nursing first? I just think they can't be expected to fulfill that role- like your psychiatrist cannot check your feet, or take your temperature.

But someone should be making sure that the care of the MH patient is holistic. Physical conditions due to lifestyle needs to appreciate that carbs, sugars, lack of motivation, are all factos that MH patients struggle with. Once a person gets the new health diagnosis it needs to be included in their care and coordinated.

I think it is the responsibility of the nurses when the patient is in hospital or acute. Once the person is not acute- they need to be trained to take some responsibility for themselves. Other community based support can be brought in too. And yeah- the drugs need to be reviewed- though I don't think enough studies are done about the impact of meds on weight......is it impacting metabolism- what is the reason persons gain weight?

Definitely agree with it being the meds.

Was going to say something similar about it being the stress of the job which makes nurses smoke. Nurses in general hospitals are the same.

My local general hospital is no smoking even in the surrounding grounds and car park. So nurses just stand centimetres from the border, on the pavement by the road smoking and drinking from mugs from their staff room on their breaks. Lol.

You don't have to train as a general nurse before you become a mental health nurse, although the very first year of training is the same academically, the practical part of the course is spent in mental health settings.

On a side note how many of the patients smoked before they had any contact with the mental health services? It would be interesting to look at that and not just blame the nurses for being a bad influence.

^ That's an interesting question actually. I didn't smoke until I came in contact with Adult MHS.

I think this study is based on a long shot. I am much more inclined to believe it is medication and lack of activity that causes obesity and diabetes in patients with illnesses primarily controlled with anti-psychotics and mood stabilizers [bi-polar and schizophrenia].

Nurses are stressed, so they smoke, patients are stressed by their illness, so they smoke.. it doesn't mean one group encourages the other. The best way to measure it seems to be asking the question of when and why a person started smoking.

Actually yes you do. All nurses have to do the Common Foundation Modules, which is general nursing, before they go into branch, and you have placements with every branch.

What a load of crap.
If anything, other patients are more of a bad example than then nurses.
They're not perfect but they're human too and they shouldn't have to completely change just because of the job they do.

But thats what I said. The first year academically is the same, although the placements are different. I took the original point as the poster asking if you have to qualify as a general nurse before specialising in mental health, the same way that you qualify as an adult nurse then chose to specialise in cardiac, respitory or even a wound care nurse.

Not true, I'm doing mental health nursing, although I have to do a year of general nursing, all of my placements will be mental health.

Im also doing mental health nursing, and you have to have placements making sure you can fill all your outcomes. Are you on the course yet or going this year?
Ive done placements in a midwifery ward, health visitor, day nursery and also I will be on a ward at some point, as well as doing a respite care placement. I have MH placements, but you have to hit medical outcomes that alot of MH wards wont be able to help you with.

I think this may be down to the way different uni's operate. I know for my mental health colleagues they are only receiving placements with a mental health focus.

Anyway, back to the original topic...

Well my reason for posting the original statement was more redundant- I think that nurses are trained in the medical care of patients. However, unless there is some sort of plan when the person is obese or has physical health conditions- it is a lot to manage in the follow up visits.

My key worker/ nurse was having a nervous breakdown and their irratic behaviour did affect me. I suppose if nurses smoke because of the stresses of their job it would affect the care they give- but then that seems more an issue with workload and a separate initiative to improve the work environment for community nurses, but not fair to blame the health of mental health patients on nurses or form a correlation.

Playing devil's advocate Archer One- maybe we have stumbled on a point in terms of the placement/ training / experience actually given to mental health nurses from their courses. Do mental health nurses feel qualified to deal with physical health conditions?

Another worthy study to do

to be fair does that then mean anyone in certain jobs (teachers, doctors, nurses god i imagine theres a huge list) have to live in a certain way because of the job they do? should anyone overweight or who smokes or who enjoys drinking be banned from doing such jobs?

I think where you train has a part to play in how confident you are as a mental health nurse in dealing with physical health conditions. But it also works the other way, I really don't feel very confident in treating the mental health problems of patients who come in for physical problems. Also, while I understand that restraint is sometimes necessary it makes me feel very uncomfortable and a little scared to see it happen.

Why? Everyone has work stresses, everyone deals with that stress in different ways. Doesn't mean their care will be any different.