Mental health clients who have diabetes or pre-diabetes have particular issues that can addressed by a multidisciplinary team approach. Lifestyle factors and the direct and indirect effects of antipsychotic and other psychotropic medications increase the risk of diabetes. Mental health clients also have greater risk of cardiovascular disease. It is important to address such risks, and many will benefit from the individual assessments and tailored education and skills training, and for some, a group setting is appropriate.

The Metabolic Consequences of Anti-Psychotics Liaison or MCAPL program comprises individual or group education sessions offered monthly by a mental health nurse, a diabetes educator and a dietitian. Clients may also be referred to an endocrinologist for a full medical review. They are first seen individually, and then if suitable, are invited to attend group sessions held one morning a month. These groups are conducted in a non-threatening environment and provide an opportunity to discuss and answer questions arising from the previous individual clinic consultations.

The program aims to provide skills and tools for diabetes self-management and to provide basic education covering the importance of good diabetic control, adequate physical activity and healthy eating, and of course, ongoing support and motivation, all in a patient friendly setting. If required, further individual follow up sessions can be arranged.

The group education sessions are very hands-on. A dietitian provides nutrition information using visual aids such as portion size models, and as well as the usual skills training in label reading, advice is given about cheaper healthy options that are easy to prepare.

There have been some issues relating to attendance and with continuity of staff that need to be resolved, but the program has committed support from both the Diabetes and Mental Health teams