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WHEEL – Weight cHange for people with sErious mEntal iLlness

  • Changing Behaviours for Better Health and Preventing Disease
  • Implementation
  • Mental Health
  • Public Health
  • Weight, Health, and Behaviour

People with Severe Mental Illness (SMI), such as schizophrenia and bipolar disorder, face significant health inequalities. These conditions can result in 15-year reduced life expectancy primarily due to cardiovascular disease. Obesity is also a key risk factor, yet many people with SMI struggle to access and engage with mainstream weight management programmes.

Social prescribing link workers, who connect patients with community-based services, could help address these barriers. However, their role in supporting people with SMI for weight management has not been explored.

The WHEEL study aimed to gather insights from two groups—people with SMI and social prescribing link workers—to understand their experiences and perspectives on using social prescribing to enhance access to weight management services. The study involved five online focus groups with 13 participants and used reflexive thematic analysis to identify key themes.

Our goal is to create a plan that works for people with SMI, and share our findings with doctors, charities, and policymakers to make sure everyone can benefit.

Impact and Implementation

  • Future research: The study provides evidence supporting a feasibility and acceptability trial, with plans for a larger-scale evaluation of the WHEEL approach.
  • Service improvements: Insights will inform the development of clearer guidance on social prescribing in weight management, potentially influencing future NHS policies.
  • Policy relevance: The findings align with NHS England’s Long-Term Plan (2019-29) and Core20Plus5 initiative, which prioritises reducing cardiovascular disease risks for under-served populations.
  • Capacity building: The project supported training for a PPIE champion and an NIHR-SPCR undergraduate intern, enhancing skills in qualitative research and patient engagement.
  • New collaborations: The study led to partnerships with Bristol Health Partners and Supported Independence, exploring further research into cardiometabolic health in people with SMI.

Next Steps

  • Conduct a feasibility and acceptability trial of the WHEEL approach.
  • Develop a randomised controlled trial (RCT) to evaluate clinical effectiveness.
  • Further explore the role of social prescribing link workers in supporting weight management in primary care.
  • Findings will contribute to future funding applications, including an NIHR Research for Patient Benefit (RfPB) Tier 2 grant.

Completed Project

Key Findings

  • People with SMI were open to receiving support from social prescribing link workers to engage with weight management programmes.
  • Social prescribing link workers were willing to help but faced challenges, such as unclear role expectations and workload pressures.
  • The study reinforced the importance of patient and public involvement (PPIE) in co-developing research methods, ensuring relevance and inclusivity.
  • Difficulties in recruiting social prescribing link workers highlighted potential workforce issues that require further exploration.
  • Findings justify further research into the feasibility and acceptability of integrating social prescribing into weight management support for people with SMI.