In response to the increased urgency to provide improved physical health outcomes for individuals with serious mental illness, the NHS Worcestershire Early Intervention Service, in collaboration with the University of Worcester, has produced an exercise and lifestyle intervention aimed at targeting the physical health and well-being of its patients. The Supporting Health and Promoting Exercise (SHAPE) programme has been specifically designed to reduce the risk of chronic disease by preventing weight gain and providing support to make positive lifestyle behaviour changes for individuals with mental health difficulties.
Research suggests patients prescribed antipsychotic medication typically present with weight gain and negative changes to blood lipids (i.e. cholesterol, triglycerides) early in their treatment which has been shown to increase the lifetime risk of cardiovascular disease and metabolic disorders (e.g. Type 2 Diabetes). However, the potential causes of death and illness which contribute to increased risk of disease and reduced life expectancy may be treated, prevented, or diminished through timely access to targeted health promotion efforts, physical health monitoring and preventative interventions.
As a health care provider you now have the responsibility to ensure adequate assessment and monitoring of the physical health needs of the mental health population. The resources available on this website are here to provide you with the necessary tools to deliver a comprehensive approach to assessment and intervention in relation to the physical health needs for patients receiving care in mental health services. The links below provide access to the SHAPE programme course materials, including educational content and downloadable worksheets and tools for clinical assessment, programme evaluation and programme delivery.
The SHAPE Programme
The SHAPE programme is a physical health intervention offered to individuals receiving mental health treatment. The 12 week intensive exercise and lifestyle therapy programme provides education and discussion on healthy lifestyle behaviors and exercise.
Weekly sessions are delivered in two parts:
• A 45 minute group education session on healthy lifestyle behaviors, including: managing anxiety and depression, mindfulness and relaxation training, substance misuse, smoking cessation, healthy eating and nutritional advice, dental and sexual health care.
• Followed by a 45 minute exercise session including activities such as circuit and resistance training, yoga, and badminton, led by qualified exercise instructors. The exercise sessions are designed to introduce participants to a wide range of activities that have proven to be effective in improving physical health and mental wellbeing in individuals with mental health difficulties.
The programme is designed to be delivered in a socially inclusive (non-clinical) group setting. In our experience, normalising the environment by positioning the intervention outside of the medical setting has shown to increase participant engagement and encourage peer support.
SHAPE is provided by clinical staff and peer support workers from designated health service teams across the UK. A member of the clinical team oversees the delivery of the educational programme and provides support to exercise facilitators.
Lifestyle sessions may be delivered by health professionals, an outside agency, or a guest speaker who is an expert in the field (nutritionists, drug worker, psychologist). Exercise sessions are delivered by a qualified fitness instructor or coach who is trained to work with this population group.
I would like to get involved in running the programme
Register for a SHAPE Account
mySHAPE.org.uk provides free access to online SHAPE programme materials to health care professionals. By creating a SHAPE account, you will be able to download the SHAPE Tool Kit which includes course instructor materials, educational and exercise lesson plans, and supporting documents for programme delivery and evaluation.
This website also provides advertisement of your SHAPE programme and can promote your programme via our Newsletter.
For access to the SHAPE Tool Kit, fill in the details below
I would like to refer a patient who is interested, what is the next step?
Prior to your patient attending the SHAPE programme, they should already have an assessment of physical health needs and baseline physiological measurements taken.
This is a mandatory requirement and your patient will not be able to join until this is completed. Details of current underlying physical health conditions and/or current treatment/medication is required prior to the start of the programme to minimise complications during exercise.
If there are any risks in relation to current mental or physical health, this will need to be clearly communicated and the patient may require individual support from the responsible clinician.
Stepping into SHAPE
An initial physical health assessment and action plan should be completed as part of the care planning process which may prompt a referral to SHAPE or other specialist services, agency or GP. Lifestyle assessment and baseline physiological measures, including BMI and waist circumference, resting heart rate and blood pressure measurements, and blood tests (lipids, glucose and prolactin) should be performed.
The following Assessment Tools provide a guide for reliably assessing physical health needs, and lifestyle risk factors for individuals experiencing serious mental health difficulties.
The SHAPE Assessment tool is a comprehensive physical health assessment document that ensures professionals meet national quality standards in relation to the assessment and monitoring of physical health needs for mental health patients.
The LESTER UK Adaptation Scale: A nationally recognised framework aimed at improving collaborative and effective physical health monitoring of individuals experiencing psychosis and schizophrenia. This framework enables health care providers to appropriately monitor and provide effective interventions to improve the physical health needs of the service user.
Physical Healthcare for People with Mental Health Problems: Actions for mental health nurses (UK Department of Health). This information aims to encourage mental health providers to take active steps to improve physical health and wellbeing of people living with mental health difficulties.
Outcomes of the initial assessment should be used in order to formulate care needs and alert providers to the necessary interventions required in relation to the individual’s physical health needs. Setting individual goals regarding physical health and wellbeing should be used as part of the care planning process; this will also help maintain and encourage the service user to take responsibility for their own physical health and wellbeing.
Following receipt of referral and necessary documentation, the patient will be invited to attend their local SHAPE programme.
All of this information, including current mental and physical health diagnosis and treatment, should be detailed on the SHAPE programme referral form. Be sure to alert staff to any current risks in relation to both physical and mental health status of the service user.
It is the responsibility of the service user/carer to contact the programme coordinator and confirm attendance onto the programme.
Physical health data may be used to audit effectiveness of the programme. BMI and waist circumference, as well as resting heart rate and blood pressure measurements are typically taken on week 1 and week 12 of the programme. This allows for determination of programme effectiveness and targeted goal setting.
*Please note individual service providers are responsible for the monitoring and evaluation of their patients physical health needs.
Participants are encouraged to attend the 12 weekly sessions and to engage in exercise classes or other physical activity outside the weekly sessions. Regular attendance and engagement supports participants to maintain a daily routine, increases activity levels and helps maintain friendships.
Following the programme, participants are encouraged to continue engaging with the exercise and lifestyle activities learned during the programme. Participants may also be provided continued access to the exercise facility, or directed to other available physical activity opportunities in their area.
A 12 month assessment of physical health needs should be completed by the health service provider to review patient’s goals and physical health status.
Physical health assessment may be needed if there are any changes in patient’s physical health needs or treatment in line with the national guidelines and local policy.