Healthy Smiles
Addressing poor oral health among people living with mental illness

Research shows that people living with severe mental illness are at a higher risk for developing oral diseases and having poorer oral health than the general population. To assist us in being able to more effectively address consumers oral health concerns Neami Health Promotions established a partnership with the Melbourne Dental School. The aim of the partnership has been to develop a capacity building approach for Neami’s support workers to assist consumers to improve their oral health.

In 2012 and 2013, an evidence-based resource was developed and implemented across Neami’s Victorian services to enable assessment, referral and support for oral health services by Neami support workers. An evaluation found that there were significant barriers to achieving good oral health existing beyond oral health literacy.

The partnership continued in 2014 with a project aimed at exploring the barriers to oral health as perceived by people living with mental illness. The objectives were to understand the way people living with mental illness defined and experienced oral health, identify the barriers to achieving oral health and identify the key factors that limit access to oral health care. Neami consulted with consumers via group and individual settings.

A number of key themes were identified. Consumer participants:

  • generally valued oral health and recognised that dental practitioners played a key role in improving their oral health
  • felt that their mental illness often overwhelmed their ability to maintain good oral health

Many participants spoke about the barriers they faced in improving their oral health, such as financial difficulty, fear, stigma, knowledge, coping abilities and communication.

Perceptions about dental practitioners varied, ranging from positive to overwhelmingly negative experiences. Participants also highlighted desirable attributes a dental practitioner should have and offered ideas on how dental services could be improved to promote optimal oral health outcomes for people living with mental illness.

The majority of participants highlighted some of the useful supports that Neami had provided, such as supporting access to dental services and reminding them of the importance of oral health.

“So with the Health Prompt… it really started the whole conversation. [My worker] helped me get all the way to the point I was in there… [it] really helped me get past my first boundary. Once I had that first visit finished, I felt more capable of doing it by myself.” (Consumer comment)

Recommendations to oral health services and Neami National were offered to promote the integration and communication between services. The research confirmed that Neami is in an ideal position to initiate conversations with consumers about oral health, offer basic oral health information and facilitate access to oral health services.

In response to the research conducted by Neami and the University of Melbourne over the last few years, training is offered annually to Neami Victorian staff to increase their skills and knowledge when working with consumers around oral health. Neami has also partnered with a PhD student to design an oral health and mental illness e-learning package which aims to build the capacity of staff to support consumers around oral health. The package will be piloted across Neami services in 2016, with a national rollout in 2017.

It is hoped that the e-learning package will eventually be made available within the broader mental health sector, contributing to a sustainable and evidence-based approach to improving oral health among people living with severe mental illness.

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