Prevention in a forensic secure service

Lead dietitian Sophie Claessens works for Avon and Wiltshire Mental Health Trust, and specifically within secure services for those with the most serious mental health illnesses. Those with serious mental illness are likely to die 20 years younger than the general population due to preventable illnesses.

The rates of overweight and obesity are also higher than the national average, with 44% of her service-users being obese. Furthermore, females are more susceptible to weight gain in secure services.

As a dietitian with experience of working in public health, it is clear to Sophie that her service-users face complex difficulties in motivation to implement weight management strategies in a one-to-one setting.

Her team needed to shape their patient’s environment to support them in embracing those healthy behaviours learnt through consultations together and create an environment which is conducive to the prevention of excess weight gain.

Working with a psychologist and occupational therapist, Sophie took on the task of creating a ‘Promoting Healthy Lifestyles Strategy’ to be piloted on the female ward, with the plans to extend it out to the rest of the hospital. Each ward team will work with their patients to agree how they will meet the strategy, be that through reducing take-aways or increasing exercise sessions.

The aim is to create an environment in which health promotion is common practice and to instil lifelong healthy habits for both staff and service-users.

It is hoped that the strategy will eventually impact all 112 service-users in the hospital, many of which have long-term admissions (up to and over three years in some cases), as well as the 350+ staff.