Arcelus J, Mitchell AJ, Wales J, Nielsen S Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011; 68:(7)724-731

Bailey S, Gerada C, Lester H, Shiers D The cardiovascular health of young people with severe mental illness: addressing an epidemic within an epidemic. Psychiatrist. 2012; 36:(10)375-378

Carney R, Cotter J, Bradshaw T, Firth J, Yung AR Cardiometabolic risk factors in young people at ultra-high risk for psychosis: A systematic review and meta-analysis. Schizophr Res. 2016; 170:(2-3)290-300

Correll CU, Solmi M, Veronese N Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017; 16:(2)163-180

De Hert M, Correll CU, Bobes J Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011; 10:(1)52-77

Department of Health, Public Health England. Future in mind. Promoting, protecting and improving our children and young people's mental health and wellbeing. 2015. (accessed 13 February 2020)

Department of Health, Public Health England. Improving the physical health of people with mental health problems: actions for mental health nurses. 2016. (accessed 13 February 2020)

Eapen V, Faure-Brac G, Ward PB Evaluation of weight gain and metabolic parameters among adolescent psychiatric inpatients: role of health promotion and life style intervention programs. Journal of Metabolic Syndrome. 2012; 1:(3)

Every-Palmer S, Huthwaite MA, Elmslie JL, Grant E, Romans SE Long-term psychiatric inpatients' perspectives on weight gain, body satisfaction, diet and physical activity: a mixed methods study. BMC Psychiatry. 2018; 18:(1)

Faulkner GEJ, Gorczynski PF, Cohn TA Psychiatric illness and obesity: recognizing the ‘obesogenic’ nature of an inpatient psychiatric setting. Psychiatr Serv. 2009; 60:(4)538-541

Firth J, Siddiqi N, Koyanagi A The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019; 6:(8)675-712

Hippisley-Cox J, Parker C, Coupland C, Vinogradova Y Inequalities in the primary care of coronary heart disease patients with serious mental health problems: a cross-sectional study. Heart. 2007; 93:1256-1262

Kisely S, Baghaie H, Lalloo R, Siskind D, Johnson NW A systematic review and meta-analysis of the association between poor oral health and severe mental illness. Psychosom Med. 2015; 77:(1)83-92

NHS England. Five year forward view. 2014. (accessed 14 February 2020)

National Institute for Health and Care Excellence. Clinical Guidance 155. Psychosis and schizophrenia in children and young people: recognition and management. Clinical guideline CG155. 2016 (updated version of 2013 document). 2016. (accessed 14 February 2020)

National Institute for Health and Care Excellence. Eating Disorders: recognition and Management. 2017. (accessed 14 February 2020)

Pasha N, Saeed S, Drewek K Monitoring of physical health parameters for inpatients on a child and adolescent mental health unit receiving regular antipsychotic therapy. BMJ Qual Improv Rep. 2015; 4:(1)

Royal College of Psychiatrists Faculty of Child and Adolescent Psychiatry. Physical health of children and adolescents. What specialist child and adolescent psychiatrists need to know and do. 2015. (accessed 14 February 2020)

Positive cardiometabolic health resource: an intervention framework for patients with psychosis and schizophrenia. 2014. (accessed 14 February 2020)

Wellbeing Wednesdays: nurse-led clinic for improving physical health care in a general adolescent inpatient unit

27 February 2020
11 min read
Volume 29 · Issue 4



Young people with mental illness are at high risk of physical health complications. Physical healthcare on a general adolescent inpatient unit is complex.


To establish a wellbeing clinic to improve efficiency and quality of the physical healthcare offered and increase health promotion.


Plan, Do, Study, Act (PDSA) cycles were used to drive this quality-improvement project. The authors audited 12 records before establishing the clinic and 12 at three further time points (6, 18 and 30 months post-intervention) to guide changes.


Results progressively improved over PDSA cycles. Time taken for initial investigations dropped. Compliance with medication monitoring and management of important physical health domains rose from zero in some cases to 100% in all but one area.


Establishing a dedicated physical health clinic in this setting is feasible and leads to improved performance against local and national standards. Mental health teams need to ensure physical health is prioritised.

On a general adolescent inpatient unit for young people with mental health difficulties (including anorexia nervosa and affective, anxiety and psychotic disorders), staff and patients identified room for improvement in physical healthcare provision. Until this point, physical health reviews and investigations were done on an ad hoc basis.

The Trust's physical health policy and relevant national guidance lists a wide range of factors to be covered, including lifestyle risk factors, pre-existing health conditions, screening, medication management and health promotion (Shiers et al, 2014; NHS England, 2014; Royal College of Psychiatrists, 2015; Department of Health (DH) and Public Health England (PHE), 2015; National Institute for Health and Care Excellence (NICE), 2016; DH and PHE, 2016; NICE, 2017). It was difficult to keep track of each person's care. Feedback from the patients indicated they wanted a planned approach to appointments and access to information on healthy living topics.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content