In it together: Physical health and well-being for people with mental illness

Lawn, Sharon

doi:10.1177/0004867411432079

Cited by 22 publications

(28 citation statements)

References 21 publications

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“…They have two to three times the mortality and morbidity from the leading chronic health conditions such as cardiac and respiratory disease [35,36]. They die between twenty and thirty year sooner than they should [37].…”

Section: Resultsmentioning

confidence: 99%

“…Smoking is the single largest cause of premature death. It is arguably the most significant contributor to poor physical health, poverty, community exclusion, and so forth, for this patient population [35]. Research demonstrates that continued smoking drives the perpetuation of cycles of instability of symptoms of mental disorder, in addition to the clear perpetuation of health and social inequalities [43,44,45].…”

Section: Resultsmentioning

confidence: 99%

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Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

Lawn

Campion

2013

IJERPH

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123

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The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders’ continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

Lawn

Campion

2013

IJERPH

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123

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“…Physicians usually tend to keep psychiatric inpatients at a distance, and psychiatrists in Japan may thus have to treat physical complications, with the exception of very severe physical conditions. Fragmentation of the physical and mental health systems is one of the barriers that hinders patients from receiving adequate care; [23] therefore, fixing the fragmented systems and increasing communication between physicians and psychiatrists could improve patients’ physical health and minimize injury from medications among psychiatric inpatients in Japan and other countries.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of adverse drug events and medication errors among psychiatric inpatients in Japan: the JADE study

et al. 2016

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BackgroundKnowledge of the epidemiology of adverse drug events (ADEs) and medication errors in psychiatric inpatients is limited outside Western countries. The nature of ADEs and medication errors are important for improving the quality of care worldwide; therefore, we conducted the Japan Adverse Drug Events Study, a series of cohort studies at several settings in Japan.MethodsThis report included 448 inpatients with 22,733 patient-days in a psychiatric hospital and psychiatric units at a tertiary care teaching hospital over 1 year. Four psychiatrists and two other physicians reviewed all medical charts and related documents to identify suspected incidents. The physicians later classified those incidents into ADEs, potential ADEs, medication errors, or exclusions and evaluated the severity and preventability if the incidents were events.ResultsDuring the study period, we identified 955 ADEs and 398 medication errors (incidence: 42.0 and 17.5 per 1000 patient-days, respectively). Among ADEs, 1.4 %, 28 %, and 71 % were life-threatening, serious, and significant, respectively. Antipsychotics were associated with half of all ADEs. The incidence of medication errors was higher in medical care units than in acute and nursing care units (40.9, 15.6, and 17.4 per 1000 patient-days, respectively). The monitoring and ordering stages were the most common error stages (39 % and 34 % of all medication errors, respectively), and 76 % of medication errors with ADEs were found at the monitoring stage. Non-psychiatric drugs were three times as likely to cause ADEs with errors compared to psychiatric drugs.ConclusionsAntipsychotic use, inadequate monitoring, and treatment of physical ailments by psychiatrists may contribute to the high incidence of medication errors and ADEs among psychiatric inpatients in Japan. Psychiatrists should be cautious in prescribing antipsychotics or unfamiliar medications for physical problems in their psychiatric patients, and should monitor patients after medication administration.

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“…Consideration of the underlying mechanisms and ways to equitably address the issues of intervention and treatment of comorbid mental-physical conditions in these populations is ongoing [30,31]. However, social capital may be particularly relevant to intervention and understanding regarding the burden associated with cardiovascular conditions and depression, which have been linked to prolonged stress responses [32-34], socioeconomic disadvantage [35] and stressful life events [36,37].…”

Section: Introductionmentioning

confidence: 99%

Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities

Allen

Inder

Harris

et al. 2013

Health and Quality of Life Outcomes

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BackgroundThe demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness.MethodsData from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness.ResultsPhysical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing psychological impairment was more marked for those experiencing financial difficulty.ConclusionsCardiovascular and affective conditions are key determinants of physical and psychological impairment. Persons affected by physical-psychological comorbidity experience greater psychological impairment. Social capital is associated with community remoteness and may ameliorate the psychological impairment associated with affective disorders and financial difficulties. The use of classifications of remoteness that are sensitive to social and health service accessibility determinants of health may better inform future investigations into the impact of context on quality of life outcomes.

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In it together: Physical health and well-being for people with mental illness

Cited by 22 publications

References 21 publications

Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

The epidemiology of adverse drug events and medication errors among psychiatric inpatients in Japan: the JADE study

Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities

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