Quality statement 5: Healthy lifestyle advice

Quality statement

Children and young people with bipolar disorder, psychosis or schizophrenia are given healthy lifestyle advice at diagnosis and at annual review.

Rationale

As they get older, children and young people with bipolar disorder, psychosis or schizophrenia have poorer physical health than the general population and a reduced life expectancy. Health problems may sometimes be linked to lifestyle factors and risky behaviours, and are exacerbated by the use of antipsychotic drugs. It is important that primary care and specialist mental health services take a proactive approach to promoting positive health behaviours from a young age by giving age‑appropriate healthy lifestyle advice at diagnosis and at annual review.

Quality measures

Structure

a) Evidence of local arrangements to ensure that children and young people with bipolar disorder, psychosis or schizophrenia are given healthy lifestyle advice at diagnosis.

Data source: Local data collection.

b) Evidence of local arrangements to ensure that children and young people with bipolar disorder, psychosis or schizophrenia being supported in primary care or specialist mental health services are given healthy lifestyle advice at their annual review.

Data source: Local data collection.

Process

a) Proportion of children and young people with bipolar disorder, psychosis or schizophrenia who receive healthy lifestyle advice at diagnosis.

Numerator – the number in the denominator who receive healthy lifestyle advice at diagnosis.

Denominator – the number of children and young people with a new diagnosis of bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection.

b) Proportion of children and young people with bipolar disorder, psychosis or schizophrenia who receive healthy lifestyle advice at their annual review.

Numerator – the number in the denominator who receive healthy lifestyle advice at their annual review.

Denominator – the number of children and young people with bipolar disorder, psychosis or schizophrenia who are supported in primary care or specialist mental health services.

Data source: Local data collection.

Outcomes

a) Obesity rates in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection. Data on BMI values are included in the 'care.data' extract for the Health and Social Care Information Centre (not specific to children and young people with bipolar disorder, psychosis or schizophrenia).

b) Physical activity in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection.

c) Drug use in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection.

d) Alcohol consumption in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection. Data on alcohol consumption are included in the 'care.data' extract for the Health and Social Care Information Centre (not specific to children and young people with bipolar disorder, psychosis or schizophrenia).

e) Smoking rates in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection. Data on smoking status are included in the 'care.data' extract for the Health and Social Care Information Centre (not specific to children and young people with bipolar disorder, psychosis or schizophrenia).

f) Infection rates for sexually transmitted diseases in children and young people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection.

g) Premature mortality of people with bipolar disorder, psychosis or schizophrenia.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as GP surgeries, community health services, child and adolescent mental health services and early intervention in psychosis services) ensure that processes are place for children and young people with bipolar disorder, psychosis or schizophrenia to receive age‑appropriate healthy lifestyle advice at diagnosis and at annual review.

Healthcare professionals (such as GPs, psychologists and mental health nurses) offer age‑appropriate healthy lifestyle advice to children and young people with bipolar disorder, psychosis or schizophrenia at diagnosis and at annual review.

Commissioners (such as clinical commissioning groups and NHS England) commission services that offer age‑appropriate healthy lifestyle advice to children and young people with bipolar disorder, psychosis or schizophrenia at diagnosis and at annual review.

What the quality statement means for children, young people, parents and carers

Children and young people with bipolar disorder, psychosis or schizophrenia should be offered advice that is suitable for their age at diagnosis and at annual review on healthy eating, how to make sure they get enough exercise, practising safe sex and the importance of avoiding drug and alcohol misuse and smoking. If they smoke, they should be given advice on how to stop.

Source guidance

Definitions of terms used in this quality statement

Healthy lifestyle advice

Age‑appropriate advice on healthy eating, physical activity, drug and alcohol use, smoking and sexual health.

[Adapted from Bipolar disorder (NICE guideline CG185), recommendation 1.8.2 and Psychosis and schizophrenia in children and young people (NICE guideline CG155), recommendations 1.3.4 and 1.5.13.]

Equality and diversity considerations

Healthcare professionals should be aware of the impact of social factors (such as inadequate housing, lack of access to affordable physical activity, poor cooking skills and limited budgets for food) on continued healthy eating and physical activity.

Healthcare professionals should take into account cultural and communication needs when giving healthy lifestyle advice to a child or young person.