Co-Designing a Women's Health Intervention with Women with Serious Mental Illness: Improving rates of cervical cancer screening and preventative HPV vaccination rates among women with severe mental illness

Background: Screening rates for common women's health conditions remain significantly low among individuals with severe mental health illness, a gap largely documented internationally and recognized by mental health practitioners in Australia including at Monash Health, which is the largest mental health provider in Victoria, providing comprehensive services in both hospital and community settings. The National Strategy for the Elimination of Cervical Cancer in Australia outlines free access to HPV immunisation for women aged 16 to 24 and free, routine cervical cancer screening for women aged 25 to 74. Lower rates of compliance with both HPV immunisation and cervical cancer screening have been observed among vulnerable subgroups of women, such as women with severe mental illness (SMI). Lower immunisation and screening rates mean cervical cancers are not detected early, and is associated with higher mortality and morbidity rates, and higher costs to the health care system. Objective: Develop a co-designed model of care aimed at enhancing rates of cervical cancer screening and preventative HPV vaccination among women with severe mental illness, with the goal of narrowing health disparities to ensure equitable physical health outcomes for this vulnerable population. Methods: To achieve the objective of developing a co-designed model of care to improve rates of cervical cancer screening and HPV vaccination among women with severe mental illness, the following methods may be employed: Literature Review: Stakeholder Engagement: Qualitative Research: Co-Design Workshops: Pilot Testing: Quantitative Analysis: Concurrently, a data-driven substudy will empirically investigate screening rates within the Australian context, shedding light on this critical issue and exploring avenues for enhancing screening uptake among this vulnerable demographic. Output: This PhD project, in partnership with women experiencing serious mental illness, aims to develop an evidence-based and co-designed model of care that effectively addresses the needs of women with severe mental illness, ultimately improving rates of cervical cancer screening and HPV vaccination to achieve equitable physical health outcomes. The main deliverable will be a co-designed new model of care that provide health services and clinicians with invaluable information, as targeted efforts to improve compliance will then greatly reduce risk of cervical cancer among these women. Through a co-design approach, the focus is on enhancing health screening uptake, addressing disparities, and fostering community engagement, ultimately aiming for tangible health benefits for this vulnerable population. The new model of care will improve uptake of immunisation among women (aged 16 – 24) and cervical cancer screening among women (aged 25 – 74) with SMI across Monash Health and other health services across Victoria. Embedded in Monash Mental Health: The successful research candidate will be embedded at: https://www.monash.edu/medicine/scs/research/centre-for-womens-and-childrens-mental-health Embedded in the Vic Govt: The nature of the research will be co-designed with the Victorian Department of Health (DH) and SaferCare Victoria (SCV). This partnership with DH/SCV in the pilot Translational Research PhD Fellowship Program offers $23,000 top-up funding for the successful candidate per year for 3 years, homing in an appropriate DH program area to facilitate data access, with public health skills support and subject matter expertise via an additional DH/SCV industry supervisor. The added value of the successful research candidate being embedded in a DH or SCV specialist program area and associated networks within the Victorian Government would provide advantages with scale and the wider dissemination of the new model of care beyond the Monash Health setting. This proposal is in line with the current DH/SCV research priorities, focusing on areas such as Women's Health and the Royal Commission into Mental Health, with themes aligned to the following Translational Research Priorities (Translational research priorities 2022–24 | health.vic.gov.au) to be explored further: • Enabling communities to improve mental health and wellbeing. • Implementation of home and integrated models of care for priority populations. • Enabling consumers to partner in health and decision making. • Implementing a learning health system for continuous improvement.