What is effective in promoting a healthy lifestyle in secure psychiatric settings? A review of the evidence for an integrated programme that targets modifiable health risk behaviours
| DOI | https://doi.org/10.1108/JFP-12-2015-0055 |
| Published date | 08 August 2016 |
| Pages | 204-215 |
| Date | 08 August 2016 |
| Author | Clive Long,Arleen Rowell,Samantha Rigg,Frank Livesey,Peter McAllister |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice |
What is effective in promoting a healthy
lifestyle in secure psychiatric settings?
A review of the evidence for an integrated
programme that targets modifiable health
risk behaviours
Clive Long, Arleen Rowell, Samantha Rigg, Frank Livesey and Peter McAllister
Clive Long is a Consultant
Clinical Psychologist at
St Andrew’s Healthcare,
Northampton, UK
and the University of
Birmingham, Birmingham, UK.
Arleen Rowell is the Head of
Nutrition and Dietetics at
St Andrew’s Healthcare,
Northampton, UK.
Samantha Rigg and Frank
Livesey are both based at
St Andrew’s Healthcare,
Northampton, UK.
Peter McAllister is the
Healthcare Director at
St Andrew’s Healthcare,
Northampton, UK.
Abstract
Purpose –The purpose of this paper is to describe healthy lifestyle initiatives in a secure psychiatric facility
and the evidence base for these interventions.
Design/methodology/approach –Following a detailed review of the literature on the physical health of
psychiatric inpatients, a trans-diagnostic approach to behaviour change is advocated in selected areas.
Findings –Lifestyle strategy proposals were produced that incorporate the principle of “libertarian
paternalism”in making changes to eating and exercise behaviour; a programme of motivational and
reinforcement strategies; and facility-specific environmental restructuring to include maximising the
therapeutic use of green space.
Practical implications –Instituting described changes needs to be accompanied by a programme of
evaluation to assess intervention-specific physical health changes.
Originality/value –This paper provides a synthesis of findings in key areas of behaviour change relevant to
improving the physical health of psychiatric patients in secure settings. It is a co-ordinated and interlinked
lifestyle strategy that has applicability to similar services.
Keywords Physical activity, Healthy eating, Lifestyle, Environmental restructuring, Green space,
Secure psychiatric settings
Paper type General review
Introduction
The national strate gy for mental health highlights the imp ortance of a commitment to focus on
physical and mental health (Griffiths, 2011). However, the research evidence has shown that
the morbidity and mo rtality rates of psychiatric and l earning disability inpatient s are higher than
those expected in the general populati on (Cormac et al., 2004). Particular groups (e.g. those
with learning disability) have significantly poorer health than their non-disabled peers
(Emerson et al., 2016) and a disproportionately higher chance of an early death. Prevalent
physical health problems include obesity, cardiovascular disease, respiratory disease, type II
diabetes, incont inence and hypert ension. Modifiab le health risk beha viours include sm oking,
poor diet and inactivity.
Received 17 December 2015
Revised 17 April 2016
Accepted 18 April 2016
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JOURNAL OF FORENSIC PRACTICE
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VOL. 18 NO. 3 2016, pp. 204-215, © Emerald Group Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-12-2015-0055
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