A role for mental health nursing in the physical health care of consumers with severe mental illness

Abstract

There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.

Perceptions of Barriers to Physical Health Care for People with Serious Mental Illness: A Review of the International Literature

“…The success of nurses advocating on other public health issues needs to be transferred to challenge gaps in overall care as a means of improving the well-being, quality of life, and longevity of people with SMI. With respect to integration of services, the mental health nurse role in physical health care within primary care and secondary care is at the proposal stage (Brunero & Lamont, 2009;Edward, Rasmussen, & Munro, 2010;Happell et al, 2011;Muir-Cochrane, 2006;Robson & Gray, 2007), while nurse-led or guided programs are in the trial and evaluation phases in the UK and the US (Druss et al, 2010;Lewis, Allen, & Warr, 2010;Shuel et al, 2010;Smith et al, 2007). The finding from the current review that there were common and salient barriers, such as difficulties reaching primary care, and diagnostic overshadowing, highlights the need for the consideration of how these barriers are addressed by initiatives thus far.…”

Care coordinator views and experiences of physical health monitoring in clients with severe mental illness: A qualitative study

“…This corresponds with previous reports that role identities and diffusion of responsibility amongst mental health staff can detract from physical healthcare provision (Baxter et al, 2016;Happell et al, 2011;Wynaden et al, 2016).…”

“…To improve physical health monitoring practices, previous literature has recommended role clarification and appointing specific members of mental health service staff as responsible for physical health monitoring (Dunbar et al, 2010;Happell et al, 2011; Working Group for Improving the Physical Health of People with SMI, 2016), and training regarding the importance of attending to physical health for mental health staff (Baxter et al, 2016;Happell et al, 2013;Wynaden et al, 2016).…”

“…This has been attributed to a range of factors (De Hert et al, 2011), including a lack of training, guidelines and general awareness of the importance of physical health monitoring (Happell, Platania-Phung, & Scott, 2013;Millar et al, 2014), concerns of increasing workloads (Dunbar, Brandt, Wheeler, & Harrison, 2010;Happell et al, 2011;Wilson, Randall, & Weaver, 2014), uncertainty amongst healthcare professionals regarding whose responsibility this task is (Barnes, Paton, Cavanagh, Hancock, & Taylor, 2007;Wilson et al, 2014), and staff attitudes regarding what falls within their clinical role (Chadwick & Withnell, 2016;Dunbar et al, 2010;Wilson et al, 2014). …”

Preventing the Development of Metabolic Syndrome in People with Psychotic Disorders—Difficult, but Possible: Experiences of Staff Working in Psychosis Outpatient Care in Sweden

“…Although there are elaborate guidelines, participants in this study illustrate that adherence to these guidelines vary; this highlights the importance of staff gaining more specific knowledge on metabolic syndrome. Knowledge about the importance of early observation and prevention of potential complications is essential in order for nurses to perform health promotion (Ganguli & Strassing, 2011;Happell, Platania-Phung, Hardy, Lambert, & McAllister, 2011;Howard & Gamble, 2011), and was also requested by the participants in this study. Although guidelines were followed, making some individuals give blood or weigh themselves was described as a problem, which may be partly explained by the cognitive functional limitations that often accompany psychotic illness (Hultsjo & Hjelm, 2012a;Viertiö et al, 2011).…”