Implementation of Early Psychosis Intervention Program ... - EENet

56o In addition, some programs noted physical health monitoring through psychiatrists,physicians in hospital, linked to a local mental health or other clinic, and in several instancesthrough the hospital emergency.Table 18: Physical health monitoringSurvey Question Response All Large Small Hospital CommunitySitesQ90: What portion of clients is being Most of the 57 60 52 70 38followed by a primary care physician? time (%)Q91: Assesses physical health issues:- PC physician % yes 85 84 86 83 86- Team nurse practitioner % yes 6 3 10 0 14- Team nurse % yes 65 84 38 67 64Main challenges to physical health monitoring noted by programs:o Access to primary care physicians – due to low availability in the area, also in some cases,PC physicians being unwilling to take on clients with serious mental illness.o Long wait times to see physicians.o Client poor attendance for lab work visits and difficulty making lifestyle changes to addresshealth issues (e.g., weight gain).o EPI staff effort and time in following up with client and/or primary care physician to ensurelab work is done, appointments are kept and information is shared.o Inconsistent monitoring and sharing of information when clients are being seen bypsychiatrists outside of EPI programs who are not familiar with EPI protocols for physicalhealth monitoring.Strategies suggested by programs for physical health monitoring:o Educating clients about importance of physical health care, teaching about healthy lifestyle,offering on-site fitness and cooking classes.o Establishing clear communication process with family physician – e.g., via sharingassessment results, regular updates, health tracking sheet.o Having access to a nurse (on the team or elsewhere) for physical health monitoring.o Having physical health assessed at each psychiatric appointment.o In small program sites, having psychiatrist assist with vitals monitoring when on site.o Have psychiatrists who are dedicated to the EPI service for greater consistency in protocolsand better communication.o Having a clinical nurse available in the districts when psychiatry comes (so clients havevitals done on same day that they see the psychiatrist)o Accessing a PC physician in a local clinic for individuals without a regular family physicianWhat would help program to provide physical health monitoring:o Access to more health professional resources (dietician services, primary care physicians,clinical nurse/nurse practitioner).o Better communication and relationships with physicians.o More flexible policies within sponsoring organization, such as being able to transport clients