Promising interventions include changes at a systems level and at the individual level (mainly trying to reduce exposure to known risk factors).
At a systems level, health care services need to increase integration between mental health and physical health care, and develop shared care arrangements between primary and secondary care.
Clinical guidelines need to clearly identify roles and responsibilities in relation to monitoring and managing physical health care.
Promising behaviour change interventions combine personalised support for smoking cessation, increasing physical activity, improving nutrition and general wellbeing. Interventions based on good evidence, which are directed by the people accessing services and work towards achieving long-term sustainable lifestyle changes, have been shown to be successful at an individual and small group level. However no simple or single approach has demonstrated long-term effectiveness.
Nutrition and exercise programmes that include the following characteristics are likely to have greater success.
- Build on existing therapeutic alliance.
- Incorporate cognitive and behavioural strategies.
- Combine exercise, dietary counselling and health promotion.
- Have realistic and/or modest outcome targets.
- Are flexible in accommodating individual needs and differences.
- Have a long-term approach and provide on-going support beyond the initial intervention
- Include group and/or social components.
- Acknowledge and take into account possible barriers to participating in such programmes.
- Have a peer support component alongside staff support and active participation.