Keeping the Body in Mind: improving physical health in young people with psychosis by Jackie Curtis
“In my dreams, I am always thin, thin and happy” Young person who gained 45 kilos on medication
“Mental and physical supports are critical to allowing us as young people with mental ill health to live it with joy, passion and enthusiasm, instead of merely existing. ”
“Improving my physical health has improved my mental health, which then improved my physical health even more. So I think the two are definitely tied.”
“What I find is great about that is that you could really, if you’re getting a bit down, doing a destructive life… if you do a bit of exercise it can send everything back into the right direction.”
Quotes from young people who have experienced psychosis
We know that getting help for psychosis early is important. That’s been the focus of the International Early Psychosis Association (IEPA) for many years. This has been mainly concerned with mental health issues until the IEPA 2010 Amsterdam conference when physical health concerns came to the fore, with the formation of the “iphYs” special interest group (international physical health in Youth stream) co-chaired by Dr Jackie Curtis (Australia) and Dr David Shiers (UK).
Subsequently through a series of international workshops in Sydney (2011, 2013) and San Francisco (2012), iphYs examined the evidence for early psychosis being a phase when changes in weight, glucose and lipid metabolism could appear within weeks of commencing antipsychotic treatment, compounded by higher exposure to other cardiovascular risks like smoking tobacco (up to 6 times commoner) and low levels of physical activity (about half as much) as peers who have not experienced psychosis.
iphYs now includes clinicians, consumers, family members, and researchers from over 11 countries. In June this year iphYs launched Healthy Active Lives (HeAL), an international consensus statement aimed at reversing the trend by tackling risks for future physical illnesses, particularly obesity, diabetes and cardiovascular disease, pro-actively and much earlier. HeAL challenges us to provide a far more holistic and preventive approach. By setting out some ambitious five-year targets HeAL emphasizes the need to tackle future physical health complications early by preventing problems like weight gain and metabolic disturbances. In particular, HeAL emphasizes the need to strengthen supported decision making by young people, and their families, to encourage optimal recovery.
In Bondi, Sydney, we now provide an integrated model of care: Keeping the Body In Mind within our early psychosis programme focusing on prevention and early intervention of physical health issues. We offer young people in our programme an on-site gym, staffed by exercise physiologists, regular individualized sessions with dietitian and metabolic nurse, and support from two youth wellness peer support workers.
It is great to see IAYMH including a focus on physical health. We know how important it is for young people experiencing mental health issues to get help early in a youth friendly, flexible way, but until recently, there has been little attention paid to physical health. We are really looking forward to sharing HeAL and the Bondi programme, as well as lots of other inspiring work promoting physical health at IAYMH Brighton. We will have many of our HeAL and iphYs collaborators, including our youth peer wellness worker together in Brighton and then in Leuven for the @EuroHeAL launch on October 3rd. For more information and to download the HeAL declaration see www.iphys.org.au