Gaps in health care for the somatic health of outpatients with severe mental illness

Abstract

The physical health of outpatients with severe mental illness (SMI) can be improved by changes in the health-care system. Analysis of current practice is necessary to develop these strategies. We compared the number of somatic health problems of outpatients with SMI with the frequency of consulting a general practitioner (GP). This was a cross-sectional study based on interviews, and records from the GP and the pharmacy. We checked whether Dutch community pharmacies had complete and correct information about the patients' medication. We observed that all patients (n = 118) had somatic problems in need of clinical attention. Patients who visited their GP less than once a year (35%, n = 42), had a mean of 2.8 somatic health problems. This was less than patients who consulted their GP more than once a year (P ≤ 0.01). In 37% of cases, the pharmacy did not have adequate information on the drug use. Many patients with SMI seemed to have insufficient contact with their GP for their somatic health problems. Insufficient information about the patients' medication suggested that the pharmacist and GP should increase exchange of information. Mental health nurses can take a lead in coordinating the care to improve somatic health for their patients.

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

“…As a consequence, they have to make extra appointments, which might give them stress. Furthermore, it should be noted that there is a subgroup of patients, which seldom visits the GP even though they experience physical health problems [16]. …”

Is Somatic Health Screening in Patients With Severe Mental Illness of Added Value?

“…Firstly, the problems detected by the somatic health screening may not have been presented to the GP by the patient. In another study, we found that patients with SMI who had less than annual contact with their GPs often had clinically relevant somatic health problems (van Hasselt et al., ). Secondly, it is possible that the GP is aware of the risk, but did not add this as a diagnosis in the medical file.…”

“…A cross‐sectional descriptive study design was used, as described in detail elsewhere (van Hasselt et al., ). Participants included 118 patients with SMI.…”

“…Yet, to our knowledge, there are no studies on help‐seeking behavior in this patient group. However, in a previous study, it was evident that patients who rarely or never visit their general practitioner (GP) may have clinically relevant somatic health problems that require a GP consultation (van Hasselt et al., ).…”

Cardiovascular Health Promotion and Consumers with Mental Illness in Australia

“…It is clear that improving access and provision of physical health care in mental health services would be of significant benefit to the physical health of consumers with SMI (Happell, Scott, & Platania-Phung, 2012a;Lambert, 2009;Lawrence & Kisely, 2010;van Hasselt et al, 2013) and may improve their quality of life and pathways to recovery. Improving cardiovascular care requires a 'whole system' approach, including mental health care (Hardy & Thomas, 2012;Lawrence & Kisely, 2010;Stanley & Laugharne, 2012).…”