What is the Impact of the Therapy Capability Framework on the Provision of Physical Health Care in a Large Publicly Funded Mental Health Service

Abstract Background People with mental illness have poor physical health outcomes. Case management approaches involve clinicians operating broadly, which can genericise scope of practice and reduce capability in addressing physical health. Capability frameworks can support evidence-informed therapies; however, their utility for promoting physical health in routine mental health care is unclear. The aims of this study were to evaluate: (i) staff capability in physical health care and the association with provision of service; (ii) changes in capability and service provision. Method A physical health care therapies capability framework (PHC TCF) was implemented at a large publicly funded community-based adult mental health service with a case management model of service. Complementary workforce development strategies for physical health capabilities were also promoted as a quality improvement initiative. Self-rated capability in physical health care over a 6-month period, and Provision of Service (POS) for physical health assessment and intervention over 12-months were analysed retrospectively. Friedman’s tests and Wilcoxon Signed Rank post-tests were used to assess change in POS; a McNemar’s test was used to assess change in PHC TCF capability levels. Associations between profession and capability levels were examined using Chi-square tests. Results Compared with allied health, the nursing profession was significantly associated with higher PHC TCF level (p < .01). Physical health assessment and intervention rates were similar between capability levels. When looking at changes over time, there was a significant increase in the provision of physical health interventions as a proportion of total POS (z = -2.69, p = .007) between the first and last quarter of the calendar year; however, there was no significant change in perceived capability levels. Conclusion Despite minimal participation in physical health workforce strategies, the proportion of clinical services provided by case managers that were classified as physical health care, increased during the 12-month implementation of the PHC TCF. Over 90% of eligible case managers used the PHC TCF. Capability data unveiled significant differences in self-reported capability levels for physical health care between nursing and allied health professionals. Engaging in supervision using the PHC TCF may have reinforced the importance of physical health treatments for case managers. This study suggests that the TCF can be an important tool to change the workforce delivery of different therapies.