Behavior Change Wheel transforming into a heart with medical symbols

Unlocking Better Health: Can the Behavior Change Wheel Transform Mental Healthcare?

Theo Raines in Health & Wellness November 2025 • 4 min read.

"A groundbreaking framework offers new hope for improving cardiometabolic screening and overall wellness for those with severe mental illness."

For individuals grappling with severe mental illnesses (SMI) like schizophrenia and bipolar disorder, the journey to wellness is often tragically cut short. Studies reveal a shocking reality: they face a life expectancy that's 10 to 25 years shorter than the general population. This isn't just a statistic; it represents countless lives impacted by a complex web of factors, including a higher risk of cardiovascular disease (CVD).

While the reasons behind this disparity are multifaceted, a key contributor lies in the fragmented nature of healthcare systems. The separation between primary care and mental health services creates significant barriers, leading to inadequate medical care for a vulnerable population. Existing models often focus on integrating mental health into primary care, leaving a gap in integrating medical care into specialized mental health settings.

But what if we could bridge this gap? What if there was a framework to design effective interventions that improve the physical health of individuals with SMI? Enter the Behavior Change Wheel (BCW), a comprehensive, theory-driven approach that's showing immense promise in transforming mental healthcare.

The Behavior Change Wheel: A Roadmap to Better Health

Behavior Change Wheel transforming into a heart with medical symbols

The Behavior Change Wheel isn't just another theoretical concept; it's a practical tool that empowers healthcare professionals to design targeted interventions. Developed by Susan Michie and her colleagues, the BCW provides a systematic way to understand and address the factors influencing health behaviors. By understanding these factors, healthcare providers can create solutions that truly make a difference.

At the heart of the BCW is the COM-B model, which highlights three essential components that drive behavior:

Capability: Do individuals have the physical and psychological skills to perform the behavior?
Opportunity: Are there social and environmental factors that enable the behavior?
Motivation: Do individuals have the desire and rationale to engage in the behavior?

The CRANIUM model provides a comprehensive strategy for community psychiatrists to expand their scope of practice, focusing on CVD risk management. The model leverages community psychiatry to increase CVD risk, including significant clinical decision support. It integrates behavioral change theory and implementation theory.

A Future of Integrated Care

The Behavior Change Wheel offers a powerful framework for addressing the complex health challenges faced by individuals with severe mental illness. By systematically analyzing the factors that influence behavior, healthcare providers can design effective interventions that promote cardiometabolic screening and improve overall health outcomes. As the CRANIUM model demonstrates, integrating behavioral change theory and implementation science can lead to feasible, acceptable, and replicable solutions that transform mental healthcare.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s13012-017-0663-z, Alternate LINK

Title: Utilization Of The Behavior Change Wheel Framework To Develop A Model To Improve Cardiometabolic Screening For People With Severe Mental Illness

Subject: Public Health, Environmental and Occupational Health

Journal: Implementation Science

Publisher: Springer Science and Business Media LLC

Authors: Christina Mangurian, Grace C. Niu, Dean Schillinger, John W. Newcomer, James Dilley, Margaret A. Handley

Published: 2017-11-14

Everything You Need To Know

What exactly is the Behavior Change Wheel and how does it aid healthcare professionals?

The Behavior Change Wheel is a framework developed by Susan Michie and colleagues designed to assist healthcare professionals in creating targeted interventions. It is not just a theoretical concept; it provides a systematic way to understand and address the factors influencing health behaviors. Understanding these factors allows providers to create more effective solutions.

Can you elaborate on the COM-B model and what each of its components represents?

The COM-B model, at the core of the Behavior Change Wheel, identifies three essential components: Capability, which involves having the physical and psychological skills; Opportunity, encompassing social and environmental factors; and Motivation, reflecting the desire and rationale. These components collectively drive behavior change.

What is the CRANIUM model, and how does it improve cardiovascular disease (CVD) risk management within community psychiatry?

The CRANIUM model leverages community psychiatry to enhance CVD risk management. It expands the scope of practice for community psychiatrists, providing significant clinical decision support. By integrating behavioral change theory and implementation theory, CRANIUM offers feasible, acceptable, and replicable solutions.

How does the Behavior Change Wheel specifically target and address the unique health challenges and disparities faced by individuals with severe mental illness (SMI)?

The Behavior Change Wheel addresses the health disparities faced by those with severe mental illness by providing a structured approach to designing interventions. By systematically analyzing factors that influence behavior, healthcare providers can create interventions that promote cardiometabolic screening and improve health outcomes. It emphasizes integration within specialized mental health settings.

What are the potential long-term impacts of integrating the Behavior Change Wheel with models like CRANIUM on the overall health and well-being of individuals with severe mental illness?

The integration of the Behavior Change Wheel and the CRANIUM model can lead to more holistic and effective treatment plans for individuals with severe mental illness. This integration can improve both mental and physical health outcomes, potentially addressing the fragmented nature of healthcare and leading to increased life expectancy for this vulnerable population by integrating behavioral change theory and implementation science.