Abstract
BackgroundPeople with severe mental illness experience physical health significantly worse than the general population. Physical health monitoring is shared between primary care and secondary mental healthcare services, though there is debate whether mental health teams should provide more physical healthcare. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear.AimsTo explore the attitudes of Community Mental Health Team (CMHT) clinicians and patients experiencing severe mental illness towards physical healthcare and its provision.Design and settingQualitative study in a CMHT setting.MethodsInterviews were carried out with CMHT clinicians and patients with severe mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis.ResultsThere were 14 patients and 15 clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring. Clinicians were aware of the importance of physical healthcare but reported barriers to provision, including lack of training, resource constraints and uncertainty in their role. There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn’t provide more physical healthcare.ConclusionsIncreasing physical healthcare provision from mental health teams requires healthcare-related barriers be addressed, but it remains unclear whether CMHT clinicians or patients believe this to be a solution.
Highlights
The mainstay of psychiatric care in the UK is delivered by Community Mental Health Teams (CMHTs)
There were patients and clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring
There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn’t provide more physical healthcare
Summary
The mainstay of psychiatric care in the UK is delivered by Community Mental Health Teams (CMHTs). It allows patients with high cardiovascular risk to be Butler et al BMC Family Practice (2020) 21:243 identified and receive personalised interventions. Completion of this physical health check is poor; only 32.3% of those with severe mental illness receive a full check [10]. It remains unclear where mental health clinicians and their patients believe responsibility for physical healthcare lies and whether this ambiguity may be a barrier to optimal patient-centred (rather than disease-centred) care. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear
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