Background and aims: Assessment screening results have identified the need for ongoing assessment and review of Dysphagia in the mental health population. Higher rates of Dysphagia, aspiration and choking have been reported within the mental health literature when compared to the general population. As a result a procedure was developed at Macquarie Hospital to address the concerns and incidents that have occurred within long and short stream mental health services. The procedure included a screening tool in which a number of nursing staff were trained by the site Speech Pathologist and instructed in its use with patients. Furthermore, staff became more observant and aware of identification of signs and symptoms of Dysphagia with their patient groups.

Method: Comprehensive training of staff, along with competency assessments in order to use the screening tool on the unit has been undertaken. Staff supported to present in services to their colleagues in consultation with the Speech Pathologist and development of mealtime management plans to assist with assessment outcomes done in a consultative manner.

Results: This tool has assisted with the identification of 35% of patients previously unidentified as having swallowing and mealtime difficulties in a number of units. The screening tool is in the process of being validated for future use in other settings.

Conclusions: Initial results showed that a focussing on a multidisciplinary and collaborative approach to the identification and management of swallowing disorders in the mental health setting has assisted with the early identification of potential high risk choking / swallowing risks / events. Research is ongoing to refine the interventions and evaluate against control groups and broadening scope of psychometric properties of the screening tool to be applicable to a wider mental health patient population.

People with mental illness experience poorer physical health and significant health care disparities, compared to the general population. Health services are well positioned to administer routine metabolic monitoring and standardised reporting templates have been developed for this purpose. However the implementation of routine metabolic monitoring remains ad-hoc [1] and the prevalence of cardiometabolic complications in this population continues to increase [2]. We conducted a retrospective file audit of electronic consumer files from a regional mental health service. Analysis showed that, of the 578 consumer files reviewed more than 60% (372 files) did not contain data using the standardised form. This is in spite of the implementation of a standardised reporting template. Inadequate training, lack of time and staff shortages may account for the low use of the electronic reporting template. Data may have been recorded elsewhere, however failure to use the easily accessible electronic form is likely to contribute to poor continuity of care and continued adverse metabolic health for people with mental illness. A range of strategies will be discussed to improve the poor reporting of cardiometabolic data.