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Referral Page

NC Healthy Active Living (NC HeAL) for Coordinated Specialty Care Teams

NC HeAL is a free healthy lifestyle program supporting the health and well-being of patients and families in early psychosis care. The program offers individual health coaching and medical nutrition therapy to patients and family members enrolled in CSC programs across North Carolina.

This page is designed specifically for CSC team members and includes direct referral access and team-specific guidance.

Refer a Patient or Family Member to NC HeAL

NC HeAL offers free health coaching and medical nutrition therapy to patients and family members enrolled in a CSC program. Referrals can be submitted by any CSC team member. A member of the NC HeAL team will follow up directly to schedule an initial appointment.

Submit a Referral →

Access to this referral form is restricted to CSC team members. For questions about eligibility or the referral process, contact NCHeAL@med.unc.edu.

What is NC HeAL?

NC HeAL provides individual health coaching and medical nutrition therapy to people with early psychosis to support adoption of healthy habits in areas such as physical activity, nutrition, sleep, stress management, substance use, and screen time. Sessions are flexible, patient-centered, and designed to complement — not duplicate — the work of other CSC team members.

How NC HeAL Fits Within Your Team

Health coaching and medical nutrition therapy work best when they are integrated into the broader CSC team rather than treated as a separate referral.

Prescriber

Monitor cardiometabolic indicators and flag patients at elevated risk. Reinforce health goals during medication reviews. A brief “how has your energy been this week?” opens the door.

Therapist / Case Manager

Explore how lifestyle factors (sleep, exercise, nutrition, stress) relate to mood and symptoms. Refer when a patient expresses interest in health goals or when motivation for change is emerging.

Peer Support Specialist

Share lived experience of lifestyle changes in recovery. Normalize the idea of health coaching. A peer saying “I started going for walks and it helped my sleep” can be more powerful than a clinical recommendation.

Supported Employment / Education Specialist

Physical activity, nutrition, substance use, stress and sleep directly affect a patient’s capacity to work or study. Connect health goals to employment goals — they often reinforce each other. Consider a warm handoff to health coaching at key transitions.

Referral Guidance

Who to refer

Consider referring when… May want to wait when…
Patient expresses interest in health, energy, or lifestyle Acute symptoms are not yet stabilised
Cardiometabolic risk factors are present or emerging Patient has expressed strong reluctance or distrust
Patient or family member asks about diet, exercise, or weight Patient is in crisis or recent hospitalisation
Patient is transitioning to work, school, or new living situation Engagement with core CSC services is not yet established

What to say when making a referral

With the patient:
“There’s someone on our team who focuses specifically on health behaviors — things like sleep, food, and staying active. A lot of people find it helpful. Would you be open to a quick conversation with them?”

What to include in the referral:
Any known cardiometabolic concerns, patient’s stated interests or goals, and any barriers to engagement you’ve already identified.

What happens after a referral?

The NC HeAL health coach will contact the patient directly to schedule an initial appointment to describe the process, answer questions and assess fit. If medical nutrition therapy is a better fit, they will be referred. Ongoing communication with the team will be on-going as the patient or their family progress through coaching or medical nutrition therapy.

Clinical Resources for the Team

These resources are designed for use during clinical visits and as take-home materials. Any team member can use or distribute them — they are not restricted to the health coach.

Why it matters: Supports cardiometabolic health, mood, and cognitive functioning in early psychosis.

📄 View Exercise Patient Handout

Clinical tips:

  • Aim for ≥150 min/week moderate activity — start lower if needed
  • Focus on small, achievable goals (e.g., 10-minute walks)
  • Address negative symptoms and motivation explicitly

Suggested clinical script:
“What’s one small type of movement that feels realistic this week?”

Why it matters: Supports brain health, energy regulation, and metabolic health — particularly in the context of antipsychotic treatment.

📄 View Nutrition Basics Patient Handout
📄 View Nutrition & GLP-1s Patient Handout
📄 View Fiber and FEP Patient Handout
📄 View False Hunger and FEP Patient Handout

Clinical tips:

  • Emphasize consistency over restriction (regular meals and snacks)
  • Pair carbohydrates with protein or fiber to stabilize energy
  • Focus on small changes (e.g., adding one fruit or vegetable per day)

Suggested clinical script:
“If you could change one thing about your food choices this week, what would it be?”

Why it matters: Sleep is essential for cognitive recovery, mood regulation, and relapse prevention in psychosis.

📄 View Sleep Patient Handout

Clinical tips:

  • Prioritize consistent wake time over bedtime initially
  • Reduce evening stimulation (light, screens, stress)
  • Encourage gradual routine-building rather than rapid change

Suggested clinical script:
“How might a small change in your sleep routine help you feel more rested and energized the next day?”

Why it matters: Stress is a key contributor to symptom exacerbation and relapse risk in psychotic disorders.

📄 View Stress Management Patient Handout

Clinical tips:

  • Normalize stress as a biological and psychological trigger
  • Teach brief skills (breathing, grounding, pause techniques)
  • Focus on routine stabilization as a form of stress reduction

Suggested clinical script:
“When stress builds, what’s something small that has helped you feel even slightly more grounded?”

Why it matters: Excessive or poorly timed screen use can impact sleep quality, attention, mood regulation, and social engagement.

📄 View Screen Time Patient Handout

Clinical tips:

  • Focus on timing rather than elimination (especially evenings)
  • Explore function of use (coping, boredom, anxiety, social connection)
  • Encourage small boundary changes (e.g., screen-free first/last 30 minutes of day)

Suggested clinical script:
“How does screen use fit into your day right now, and is there any part of it that feels like it’s working against your sleep or recovery?”

Why it matters: Nicotine use is associated with increased cardiovascular risk and can complicate cognitive and psychiatric outcomes in FEP.

📄 View Nicotine Reduction Patient Handout

Clinical tips:

  • Assess readiness rather than pushing immediate cessation
  • Normalize ambivalence about quitting
  • Offer incremental reduction strategies (delay, reduce, substitute)

Suggested clinical script:
“Would it be okay if we talked about what you like and don’t like about nicotine right now?”

Why it matters: Alcohol can worsen cognition, mood instability, and increase relapse risk in psychosis.

📄 View Alcohol Reduction Patient Handout

Clinical tips:

  • Use a non-judgmental, harm-reduction approach
  • Explore function of use (stress, sleep, social anxiety)
  • Focus on patterns rather than labels (e.g., when/why use occurs)

Suggested clinical script:
“What role does alcohol play for you right now, and are there times you’d like that to look different?”

Downloadable Resources

The following resources are available to download, print, and share with patients, families, or team members. Upload links will be active once files are hosted on the site.

Resource Best for Download
📄 Move Well · Feel Better
A beginner’s guide to getting active — covering strength, coordination, balance, and cardio with beginner-friendly starred movements.
Patients & families ⬇ Download
📄 Eat Well · Feel Better
A gentle guide to nourishing your body — food groups, building a meal, a 7-day sample meal plan, and easy ingredient swaps.
Patients & families ⬇ Download
📄 Patient Action Planner
A simple one-page worksheet to help patients identify a short-term health goal, explore their motivation, plan small steps, and track progress.
Patients & health coaching sessions ⬇ Download
📦 All Patient Handouts (Bundled)
Complete set of topic-specific patient handouts — exercise, nutrition, sleep, stress, screen time, nicotine, and alcohol.
Waiting rooms & distribution ⬇ Download