The University of Michigan-Flint School of Health Professions and Studies (SHPS) has an ongoing partnership with Lapeer County Community Mental Health (CMH) that is working to improve the fitness, physical health, and overall well-being of people who have severe mental illness such as schizophrenia, bipolar disorder, and major depression.
One outcome of the partnership has been the implementation of a fitness training program in Lapeer called InSHAPE. This program is designed to lower risk factors that contribute to alarming rates of chronic disease and shortened life spans in individuals with mental illness.
According to a report published in 2006 by the National Association of State Mental Health Program Directors, persons with serious mental illness live, on average, 25 years less than the general population. People with serious mental illness die from the same diseases as the general population but at younger ages. Reasons for this gap are complex and include poor eating patterns, low physical activity levels, high percentages who smoke, negative effects of antipsychotic medications, and lack of adequate screening and treatment of chronic disorders.
Since 2009, UM-Flint Assistant Professor of Nursing Marsha Lesley, Ph.D, has been leading an initiative to improve the physical health of individuals with serious mental illness. According to Professor Lesley, the impetus for the InSHAPE program came from interactions that took place between members of the Lapeer County CMH-sponsored clubhouse called Harmony Hall and UM-Flint nursing faculty and students.
"We were invited to brainstorm with clubhouse members and staff to find ways to promote healthier lifestyle habits," said Lesley. "Nurse practitioner students evaluated clubhouse members' health, conducted focus groups to learn about their physical activity interests, and teamed up to operate a lemonade stand during the 2010 CRIM Festival of Races weekend in Flint."
The search for ideas led to Genesee County Community Mental Health where the InSHAPE program was already going strong. Lesley brought administrators, staff, and clubhouse members from Lapeer and administrators, faculty, and students from SHPS' nursing and physical therapy departments together at Genesee County CMH to learn more about the program and how it could work in Lapeer. InSHAPE was quickly approved by the Lapeer CMH Board and enrolled its first participants in December 2010.
InSHAPE is a health promotion program initially developed at Monadnock Family Services in New Hampshire where it is now being implemented statewide. Individuals who sign on to the year-long InSHAPE program aim to improve their cardiovascular fitness and nutritional health. In Lapeer, they do so by initially working one-on-one with a personal trainer and use exercise equipment located in the CMH facility. They then gradually move into group fitness activities offered both onsite or at local community sites. Trainers keep track of individual progress using a software program created by faculty and a graduate student from UM-Flint's Physical Therapy department.
Twenty participants have completed the year-long InSHAPE program. Lesley is currently interviewing many of these "graduates" to learn about their experiences and intentions for continuing with their fitness efforts now that they have completed the program.
"This work," noted Lesley, "funded by a Faculty Research and Creative Activity grant, may help us to determine what helps InSHAPE participants to persist with behavioral changes over time."
UM-Flint Department of Nursing Director Margaret Andrews said, "This relationship is a win-win-win for people with mental health challenges who live in Lapeer County and their families, the staff at Lapeer County Mental Health, and UM-Flint students and faculty in nursing and physical therapy. It's important to provide care for both the mental and physical needs of patients."
Dr. Robert Sprague, CEO of Lapeer CMH agrees that the partnership has produced very positive results. He said, "Our Club Members are receiving more integrated and preventative health care. We have people who have lost weight and reduced medications for diabetes and other medical conditions. This is a great project and its success is spreading in St. Clair and Sanilac Counties, where they are seeing similar results."
Professor Lesley said, "The partnership between our nursing department and Lapeer CMH continues to grow with plans now directed toward bringing RN to BSN students from our nursing program on site for their clinical rotations in community health nursing. Students will have clinical practice opportunities that take place within a recovery model of care, and can contribute to additional creative ways to address the physical, social, and mental health needs of individuals with serious mental illness."