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Developing effective models of identifying and managing physical health problems amongst mentally ill populations has become a more pressing issue in recent years as the prescription of Second Generation Antipsychotics (SGAs) has burgeoned. Some of the side effects commonly associated with SGAs such as weight gain and metabolic disorders have potentially devastating effects on health and well-being, increasing cardiovascular risk and the incidence of diabetes. The Well-Being Support Programme (WSP), a nurse-led service, was designed to provide a care delivery system whereby physical problems could be identified and appropriate treatment and monitoring initiated by prompt referral to suitable specialist services or general practitioners, forging strong links between primary and secondary care and ensuring that mentally ill patients with physical health problems were receiving holistic care packages. Other problems such as unhealthy lifestyles and obesity were managed by the Nurse Advisor running the programme. Interventions such as weight counselling and groups, and structured exercise programmes were beneficial in terms of encouraging healthier lifestyles, managing obesity and improving self-esteem. This paper describes the manner in which the service was set up and implemented, demonstrating an effective model for identifying and managing physical health problems in the mentally ill. [ABSTRACT FROM AUTHOR]

UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective. [ABSTRACT FROM AUTHOR]