Mental health non-government organisations (NGOs) are especially well placed to improve the physical as well as mental health of clients. The Healthy Living Toolkit is a suite of resources to help NGOs succeed in this, including the Healthy Living Guidelines and other materials.
Sustainability
Ensure sustainability by integrating healthy living into the organisation’s everyday practice.
Many measures in these Guidelines can be implemented at little or no cost to the organisation by adapting regular practices, drawing on available resources, and linking clients with community initiatives. For example, there is little or no cost in scheduling a regular chat about physical health, or simply going for a short walk with a client rather than sitting at a café or fast food restaurant. The most important aspects of a healthy living initiative are changes to culture and attitudes.
If designated funding is required, funding sources may include the Australian and State governments, philanthropic trusts and foundations, and local government support. Fundraising events can also involve healthy living promotion and activities – such as a sponsored walk, for example.
Environment
Once your organisation has built a solid framework for supporting the physical wellbeing of clients, the goal is to create a health-promoting environment for clients (and staff). That is an environment that helps people to increase control over, and to improve, their own health.
To create this environment, NGOs can provide information on SNAP (The SNAP factors are defined by the Royal Australian College of General Practitioners as: Smoking, Nutrition including caffeine, Alcohol and Physical activity) risk factors to all staff, volunteers, peer workers, clients and their families. Information can also be given on managing chronic conditions such as heart disease and diabetes.
Encourage and facilitate regular physical health checks such as blood pressure and waist measurements.This does not mean staff conducting these checks, but rather:
- Being aware of a client’s state of physical health (through observation or direct enquiry) and ensuring any needs identified are addressed.
- Empowering and supporting clients to ask for physical health checks at their GP or other health service.
- Integrating promotion of physical health checks into normal practice, and make the monitoring of physical wellbeing by clients a regular, systematic process. Using a physical health checklist to initiate conversations about risk factors and symptoms can help with this. Formal physical health checks (at a GP or other health service) for this high-risk group are recommended every six months at least.
Provide a smokefree environment and offer access to smoking cessation supports. Offer physical activity and healthy eating programs.
Offer one-on-one and group support to build and sustain motivation for health behaviour change, using techniques such as health coaching (for chronic illness self-management support).
Develop the personal health skills of clients including self-advocacy skills and essential basic life skills such as food shopping, cooking and budgeting. Empower clients to work effectively with a GP by helping them make an appointment, offering to go along with them to an appointment if needed, and improving their understanding of basic physical health checks.
Tap into peer leadership as the shared understanding of the everyday challenges of living with a mental illness between peer worker and client means that the worker can greatly influence positive health behaviour change in clients, and act as a positive role model.
Involve friends and families where possible, as their attitudes and behaviour regarding food and physical activity are important. Research has shown that most people with mental illness want support from friends and family and believe that their encouragement would help them to achieve their goals. Provide them with information about resources, programs and services and involve them in activities if appropriate.
Link with community and public health initiatives such as the many government-approved public lifestyle programs aimed at people at risk of chronic conditions. Many of these are either free or low cost.
Acknowledge gender and cultural differences. Gender as well as cultural and religious background can influence people’s health attitudes and behaviours. Ensure your organisation acknowledges these differences and makes the most of them by tailoring messages and programs accordingly.
Framework
Providing support for the physical wellbeing of clients is about more than putting up a few ‘healthy eating’ posters or ‘no smoking’ signs. It requires a systemic, coordinated approach from the organisation to ensure real changes to practice are made, and that those changes mean real improvements for clients. Organisations need to ensure a good framework is in place for this to occur. Poor access to relevant resources or expertise, limited funds to support staffing and program expenses and staff attitudes, behaviour, time and competing priorities can get in the way. A good framework can help overcome these barriers.
Key strategies for a good framework are:
- Ensuring the full support and commitment of board and management by making a strong case for change.
- Using these Guidelines to develop a practical, evidence-based policy for your organisation.
- Consulting clients about their physical health needs, and how your organisation could help them address these.
- Appointing a coordinator to oversee the initiative.
- Finding out about staff attitudes and behaviours beforehand through staff surveys and forums.
- Preparing staff by training, personal development, official launches, making the initiative fun, and allowing plenty of time for staff to discuss any concerns.
- Recruiting enthusiastic staff as site champions, if your organisation operates over multiple sites.
- Encouraging staff to improve their own physical health, so they feel confident about the issue and can model healthy behaviours.
- Embedding the change, by including the policy in strategic plans, position descriptions and staff recruitment processes.
- Building partnerships with local health services including GPs, clinical services, community health centres and other NGOs.
- Tapping into existing resources and expertise by linking with relevant health organisations.