The DMH Net Metabolic Syndrome Screening Initiative started in 2008, and is designed to identify and manage individuals with serious mental illness that are at risk for diabetes. The program is a joint initiative of the MO Department of Mental Health (DMH), the MO Coalition of Community Mental Health Centers (CMHC), the MO Primary Care Association (PCA) and The Independence Center. CMT has assisted in the development and delivery of a number of features of this initiative, including:

Training for CMHC Nurse Liaisons

  • All Nurse Liaisons have been provided with resources and training in “Diabetes for Case Managers”, and a copy of “Living with Diabetes”, the American Diabetes Association’s handbook for diabetics
  • All Nurse Liaisons have received specialized training in the provision of psychoeducational classes on improved physical health to clients.
  • Through collaboration with The Independence Center of St. Louis, additional training was provided to assist Missouri CMHCs with integration of health promotion activities within their agencies through the “Take Charge” program.

Psychoeducation for CMHC Patients

  • Classes cover such topics as diabetes, smoking cessation, and obesity prevention, and include the Diabetes Conversation Maps teaching tool, and materials from the Freedom from Smoking and Solutions for Wellness programs. These classes have increased patients’ ability to manage their physical healthcare.

Training in Mental Illness for Diabetic Educators

  • Diabetic educators throughout Missouri have been trained on the topic of serious mental illness and how to modify their teaching styles to improve effectiveness for individuals with mental illness through the American Association of Diabetic Educators (AADE). Materials developed by CMT for this training were also used to train nurses at a national diabetes conference.

Screening and Monitoring of Key Health Indicators

  • Starting January 1, 2010, all Community Psychiatric Rehabilitation (CPR) programs began providing annual screenings for risk factors of metabolic syndrome for all adults and children receiving antipsychotic medications in the previous 12-month period. The screening monitors:
  • Vital signs (height, weight, body mass index (BMI) and/or waist circumference)
  • Blood pressure
  • Blood glucose levels (fasting blood glucose test and/or hemoglobin A1c test)
  • Fasting lipid panel (total cholesterol, HDL, LDL, triglycerides)

The results of the screenings will be entered into the CyberAccess registry. Follow-up screenings are conducted for individuals with abnormal results.

Patients who are found to be at risk for metabolic syndrome are offered onsite education using Diabetes Conversation Maps or are referred to certified Diabetes Self Management Education sites.