Improvement of care for the physical health of patients with severe mental illness: a qualitative study assessing the view of patients and families

Fenneke M Van Hasselt,Marian Jt Oud,Anton Jm Loonen

doi:10.1186/1472-6963-13-426

Abstract

BackgroundPatients with severe mental illness (SMI) experience more physical comorbidity than the general population. Multiple factors, including inadequate seeking of healthcare and health care related factors such as lack of collaboration, underlie this undesirable situation. To improve this situation, the logistics of physical health care for patients with SMI need to be changed. We asked both patients and their families about their views on the current organization of care, and how this care could be improved.MethodsGroup and individual interviews were conducted with patients and family of patients to explore their needs and preferences concerning the care for the physical health of patients with SMI, and to explore the shortcomings they had experienced. Using thematic analysis, responses were firstly divided into common topics, after which these topics were grouped into themes.ResultsThree major themes for the improvement of the physical care of patients with SMI were found. Firstly, the reduced ability of patients with SMI to survey their own physical health interests requires health care that is tailored to these needs. Secondly, the lack of collaboration amongst mental health care professionals and general practitioners (GPs) hinders optimal care. Thirdly, concerns were expressed regarding the implementation of monitoring and supporting a healthy lifestyle. Patients with SMI welcome this implementation, but the logistics of providing this care can be improved.ConclusionsAn optimal approach for caring for the physical health of patients with SMI requires a professional approach, which is different to the routine care provided to the general public. This approach can and should be accomplished within the usual organizational structure. However, this requires tailoring of the health care to the needs of patients with SMI, as well as structural collaboration between mental health care professionals and GPs.

Highlights

Patients with severe mental illness (SMI) experience more physical comorbidity than the general population
Patients and family carers state that an optimal approach for caring for the physical health of patients with SMI requires a different professional approach than the routine care for the general public. This approach can and should be accomplished within the usual organizational structure, but professionals should tailor the care provided to the needs of patients with SMI
Collaboration between mental health care providers and General practitioner (GP) is very important, especially at a time when most patients with SMI are treated as outpatients

Summary

Introduction

Patients with severe mental illness (SMI) experience more physical comorbidity than the general population. Multiple factors, including inadequate seeking of healthcare and health care related factors such as lack of collaboration, underlie this undesirable situation To improve this situation, the logistics of physical health care for patients with SMI need to be changed. Patients with severe mental illness (SMI) have more physical comorbidity than the general population [1] This is caused by multiple factors such as substance abuse, poor diet, lack of exercise, inadequate seeking of physical care, side effects of medication, and health care factors [2]. A case manager performs the community care for chronic psychiatric patients This mental health nurse is responsible for several patients with SMI and confers with a psychiatrist when necessary. Families form an important part of the support network for patients with SMI, performing informal care by ensuring medication compliance and providing support in recovery and risk management [6]

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Discussion

Conclusion