People with severe and relentless mental illness such as schizophrenia and bipolar disorder also bear a greater physical burden; they are at increased risk for obesity and chronic diseases including diabetes, hypertension, cardiovascular disease, and nicotine dependence. Serious mental illness is an important risk factor for morbidity and mortality; these patients die an average of 25 years earlier than the average individual due to higher rates of medical illness than can lead to premature mortality.
These gloomy statistics inspired Ken Jue, MSW, CEO of Monadnock Family Services in Keene, New Hampshire to start the In SHAPE program. “What we’re trying to do is prevent premature death of persons with serious mental illness,” says Jue.
Research shows that people with schizophrenia and other psychotic and mood disorders who exercise three times a week for approximately 4 months lose weight, gain cardiovascular fitness, and experience less depression and fewer psychiatric symptoms. But few programs exist to help people with SMI maintain healthier lifestyles; for example, fewer than 20% of people with schizophrenia engage in regular exercise, and approximately 40% are completely inactive. In SHAPE is one of the few wellness and prevention program for individuals with SMI that seeks to fill this void.
In SHAPE seeks to improve physical health and quality of life, reduce the risk of preventable diseases, and enhance life expectancy of individuals with SMI. Each participant is teamed up with a trained health mentor to create a Self Health Action Plan for Empowerment (SHAPE) that includes physical activity, healthy eating goals, and attention to medical needs. The program enrolls adults in community wellness activities such as exercise, dance classes, weight loss programs, and smoking cessation activities.
Until 2002, Jue continued to attend a number of funerals of his patients that seemed far too young to be dying. He often looked at his patients’ photographs and noticed that they all looked youthful and active at one time in their lives. Jue started researching information about co-morbid medical illnesses among people with SMI and also interviewed Monadnock staff about patients’ medical conditions. Staff members confirmed that many of their patients had died prematurely or had a number of other chronic health conditions exacerbated by their lifestyle choices and their mental illness. Jue knew something had to be done to help this unique population, and so he outlined key program elements that he would want to see in a program that helped people with SMI improve their physical health.
Instead of relying on formal referrals from mental health providers, Monadnock encouraged voluntary participation and began to form partnerships with hospitals and organizations that would provide exercise, nutrition, and general health services. These partnerships were critical to In SHAPE’s success. The local hospital provided smoking cessation programs, while a large non-profit medical clinic provided primary care services to participants without a medical home at no charge to the patient. The local YMCA and a dance and fitness center also offered up their services to encourage creative forms of physical activity. Graduates from …