Much of the relevant information for Australian community mental health care screening is found in 5.

2 Community
Mental Health Care Screening.

In this, it suggests that physical examinations be conducted in a manner consistent with standards for initial
examination at least on a yearly basis.
It also includes yearly examination for potential movement disorders if any risks are identified.

Following from the guidelines for initial physical examination, this includes the following.
Observations, including BP, pulse, RR and temperature.
Weight and waist-hip ratio or waist measurement
Examination of respiratory, cardiovascular and gastrointestinal systems
Neurological examination

It notes that these can also be performed by a GP.

4.4 indicates that all investigations are to be guided by history and physical examination and none should be considered
routine. A list of investigations are provided, but little specific guidance is given beyond initial screening.

The NSW guidelines draw evidence from thirty seven documents in its reference section.

Mind, Body and Heart: Psychotherapy and the Relationship between Mental and Physical Health M A T T H E
W B AM B LI N G

Focused upon mental health causing worsening physical health. Advocates use of psychological and psychotherapy
measures to improve physical health; notes worsened rates of cardiovascular disease and diabetes amongst those with
mental illness and discusses mechanisms of mind-body interrelation. No discussion of physical health screening.

Barbara Mauer (2006) Morbidity & Mortality in People with Serious Mental Illness. National Association Of
State Mental Health Program Directors

A wide-ranging document that is nonetheless quite USA specific, with concrete goals set out for federal, state and local
levels. Encourages a holistic approach to health disparities, including safe housing, income protection, skills-based
prevention programs, actively addressing substance issues and case managenment.

III-D describes guidelines for diabetes management in a schizophrenic population, which are based strongly on the
national guidelines for management of the diabetic population.

The document contains additional recommendation that ongoing surveillance methods be put in place for those with
mental health problems. This includes adding fuller measures of health behaviors into screening, including smoking,
BMI, diet and exercise.

Whilst not giving specific recommendations for investigations in the well mental health patient, it advises that all new
screening projects need to plan from the beginning to gather and use data regarding their efficacy and cost. Appendix 1
provides documentation for these.

Couzos S, Murray R (eds) (2007) Aboriginal Primary Health Care, 3rd Edition. Oxford: Oxford University
Press.
Full text of book could not be accessed.

J, Todd G, Morrow H, and Sheldon K (2001) Mum, I used to be good lookingLook at me now: The physical
health needs of adults with mental health problems: The perspectives of users, carers and frontline staff.
International Journal of Mental Health Promotion 3 (4 ): 16-24.

Full text could not be accessed through hospital databases.

Department Of Health, UK (2006) Choosing Health: Supporting the physical needs of people with severe mental
illness Commissioning Framework. England.
Suggests that integrated framework for care would be beneficial. Suggests yearly basic health checks, lifestyle
assessments and blood tests. No further specific guidance.
Advises that the nurse lead should also establish specific programmes on healthy living, weight management and
physical activity advice, as well as more general, ongoing support sessions for individuals and groups.
Potentially useful for wellness clinic models.

Department of Human Services Victoria., Sharing the Care: General Practitioners and Public Mental Health
Services. 1996, Melbourne: Human Services Victoria

Could not locate online or through databases.

Human Services Victoria. Emergency Care Community of Practice: Mental Health Emergency Care Interface
Project 20042006. (2006) National Institute Of Clinical Studies, Melbourne

Focused heavily upon emergency departments and mental health, rather than ongoing community care. No guidance on
ongoing investigations.

Garden, G (2005) Physical examination in psychiatric practice . Advances in Psychiatric Treatment. Vol 11 , pp.
142-149.

A practical guide for physical examinations in psychiatry, but no guidance on specific investigations.

Quality of diabetes care among adults with serious mental illness. Psychiatric Services. Vol 58 , pp. 536-543.
Suggests that individuals with diabetes and serious mental illness have worse diabetic care, based on both non veteran's
affairs and veteran's affairs hospital charts. No guidelines for investigations.

Greening, J (2005) Physical health of patients in rehabilitation & recovery: a survey of case note records .
Psychiatric Bulletin. Vol 29 , pp. 210-212.

Details poor physical health monitoring in psychiatric patients based on case notes. Notes the absence of clear
guidelines for physical health review.

Guy W. ECDEU Assessment Manual for Psychopharmacology. Revised. (DHEW Publ No ADM 76-338).
Rockville, MD: U.S. Department of Health, Education, and Welfare, Alcohol, Drug Abuse and Mental Health
Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs,
1976, pp 534-537

These pages simply explain what AIMS is.

Harris, Jane, comp. Submission to The Disability Rights Commission Closing the Gap Rethink. 2005. 1-21. 18
Mar.-Apr. 2008 . Health Records and Information Privacy Act 2002 (NSW).

No longer accessible online. Have contacted Rethink.org to request copy of document.

Health Records and Information Privacy Act 2002 (NSW)

No guidance available for specific physical health screening.

Koran, L Medical disorders among patients admitted to a public- sector psychiatric inpatient unit. Psychiatric
Services. [Online]. Vol 53. issue 12, December 2002 , pp. 1623-1625. Available at accessed 31 August 2007

Only addresses inpatient screening.

Page 41- 49 discusses aboriginal mental health issues. Later in the text, the thirty two primary recommendations do not
specifically discuss physical health screening. I did not review the two hundred and sixty five pages of appendices,
limiting myself to the primary text.

Lambert, T & Chapman, L (2004) Diabetes, psychotic disorders & antipsychotic therapy: a consensus
statement. MJA. Vol 181 15 November, pp. 544-548
Provides guidelines for monitoring of patients initiated on an antipsychotic. Suggests that individuals on an
antipsychotic should automatically be treated as a high risk group requiring 3-monthly waist-hip ratio measurements, 6
monthly lipid and blood pressure measurements, and finger prick blood sugar levels six monthly.
Duty to Care - Preventable physical illness in people with mental illness
In my office.

Leucht, S & Fountoulakis, K. (2006) Improvement of the physical health of people with mental illness.
[Editorial] Current Opinion in Psychiatry. Vol no 19, pp. 411-412

Purely editorial- no guidance on physical health screening.

Linda Seymour (2003) Not all in the mind: The Physical Health of Mental Health Service Users. mentality, UK.
References
https://www.scribd.com/document/128460599/not-all-in-the-mind#
Full text not available online.

McCreadie, R (2004) Diet, smoking & cardiovascular risk in people with schizophrenia. British Journal of
Psychiatry. vol 183 2003, pp. 534-539.

Descriptive study only, no specific evidence for investigation guidelines.

Mental Health Act 2007. (NSW)

No specific evidence for investigations.