Mental Health

SHAPE: Support for Health Anxiety at the Prince of Wales Hospital – An Exploratory Study

Project Lead
Dr Michael John Murphy
FRANZCP
MRCPsych

Dr Michael John Murphy

FRANZCP
MRCPsych

Dr Michael John Murphy

FRANZCP
MRCPsych

Dr Michael John Murphy is a consultation liaison psychiatrist working at the Prince of Wales hospital and Orange Health Service with medical, surgical, and intensive care patients who have a co-occurring mental health difficulty such as depression, psychosis or delirium, providing expert assessment and advice to the patient, family members and health care staff.

He previously worked, and then held an honorary appointment, at the Clinical Research Unit for Anxiety and Depression (CRUfAD), a joint venture of St. Vincent’s hospital, Sydney and the School of Psychiatry at UNSW.

Dr Murphy’s PhD from the School of Psychiatry, UNSW, examined the role of internet-delivered cognitive behavioural therapy (iCBT) in the treatment of depression and/or anxiety in cancer patients, including  randomised controlled trials to evaluate iCBT in early stage and advanced stage cancer and in cancer survivors. He has also studied patient care in eating disorders, managing blood-borne viral illnesses in mental health patients, and teaching doctors how to assess patients’ decision-making capacity.

About one-third of people with a chronic physical health condition, such as diabetes, heart disease or cancer, also experience depression or anxiety at some point during their illness or treatment. These coexisting mental health issues can have significant effects on both the individual’s mental well-being and their physical health outcomes.  

Mental health problems can exacerbate certain physical diseases through biological mechanisms. For example, conditions like depression and anxiety can lead to increased inflammation and hormonal imbalances, which can worsen the progression of diseases.  

By introducing new models of care for individuals with health-related anxiety, it is possible to improve the quality of treatment while simultaneously enhancing the efficiency of health systems.  

About the project

The SHAPE project tested an approach to mental health screening and managing health anxiety in medical or surgical clinic patients at the Prince of Wales Hospital. People with high health anxiety were offered interventions including a free online evidence-based therapy course or received care from a specialised team of clinicians via telehealth. The researchers used data linkage to evaluate whether psychological test scores correlated with general hospital attendance in the preceding years. The project also: 

  • Ran focus groups to explore how doctors viewed anxiety in people with physical illness
  • Reviewed the academic literature on rates of anxiety in people with physical illness 

Who is it for?

People who attended specific medical and surgical clinics at Prince of Wales Hospital, Sydney underwent screening to identify those with health-related anxiety. This proactive approach aimed to identify individuals who may have experienced excessive worry about their health. They were invited to participate in a multidisciplinary and multifactorial study designed to improve their symptoms and enhance their access to appropriate care.  

The study involved an assessment of each participant’s health anxiety, considering both physical and psychological factors contributing to their distress. A team of healthcare professionals, including physicians, psychologists, specialised nurses, social workers and exercise physiologists collaborated to develop personalised care plans.  

What is involved?

To address the challenges associated with health-related anxiety, Mindgardens provided support to the project team to establish multisite collaborations involving South Eastern Sydney Local Health District (SESLHD), the Black Dog Institute, UNSW Sydney and Neuroscience Research Australia (NeuRA). Researchers from these organisations came together to develop online screening tools to identify individuals with early symptoms of depression or anxiety.  

Achievements and Outcomes

This was the first successful design and trial of a hybrid online and physical intervention for people with health anxiety in general medical and surgical outpatient settings, with a high prevalence of health anxiety identified during digital screening. 

Intervention delivered significant reduction in scores on health anxiety, generalised anxiety, suicidal ideation, and number of doctor visits in the 6 months after treatment, compared to the 6 months before treatment.  

The trial team included a position for an early career clinician researcher to support their PhD thesis work.  

Project Status

This project was active from January 2020 – September 2023 and has been successfully completed. 

Funding Sources

  • Commonwealth grant funding awarded by the Australian Government Department of Health and Aged Care

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