A review of lifestyle interventions for individuals with serious mental illness shows that successful interventions can make a significant impact on the health and well being of this vulnerable population. The review was recently published in the Journal of Clinical Psychiatry.

Individuals with serious mental illness die an average of eight years younger than members of the general population, with cardiovascular disease and related risk factors accounting for the majority of deaths. Emory researchers sought to synthesize the common factors for success in lifestyle interventions, and to identify specific considerations in adapting these models for those with serious mental illness.

“People with serious mental illness often lead sedentary lives and eat more saturated fat and fewer fruits and vegetables than the general population,” writes study author Martha Ward, MD, Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine. “Additionally, these individuals have elevated rates of tobacco use, metabolic syndrome, obesity and diabetes - factors that create significant risk for cardiovascular disease.”

The researchers found that successful lifestyle intervention programs employ multiple components (including diet, exercise and behavioral therapy), are tailored to specific patient needs, are of longer duration, provide frequent contact, and utilize trained treatment providers.

Successful lifestyle interventions may include:

• Education on healthy food choices through visits to grocery stores and cooking demonstrations

• Recommendations to exercise at moderate intensity for 30 minutes a day, most days of the week, and combine exercise with dietary interventions

• Personalization of diet and exercise regimens to increase patient participation

• Tailoring of diet to include patient food preferences, occupation, family environment and social support

• Use of Cognitive Behavioral strategies including goal setting, self-monitoring of food intake and physical activity

• Use of structured curricula that target patients’ perception of their ability to manage their health behaviors

• Treatment duration of at least four-to-six months

• Increased frequency of interaction with treatment providers

• Utilization of multidisciplinary teams that include both professionals and lay leaders

The researchers go on to say that though successful lifestyle interventions in the general population may inform the creation of programs for those with serious mental illness, addressing the unique needs of these patients is also an important step in program development. 

“Intensive and multifactorial programs may be necessary to combat symptoms of mental illness, and creative solutions to socioeconomic limitations are essential,” say the authors.