Minding our own bodies: Reviewing the literature regarding the perceptions of service users diagnosed with serious mental illness on barriers to accessing physical health care

Abstract

International studies consistently demonstrate that individuals diagnosed with severe mental illness (SMI) have an increased risk of co-morbid physical health problems and premature death. During the past decade, government policy in the UK has focused on improving the physical health of those with SMI. Despite this, international research has continued to report barriers to accessing appropriate services. These have been identified as emanating from service users and professionals alike, and also from institutional bureaucracy. Most of this research has reported difficulties from the perspective of various professional groups, with little attention being paid to the service user voice. Studies from the service user perspective undertaken in the past 10 years equate to six qualitative and three quantitative studies, and it appears that poor physical health care remains a problem in the developed world. The quality of this care is compromised by practical problems and interpersonal difficulties between service users and health-care providers and between providers of mental health services and those providing physical health care. This paper presents a review of the nine international studies and discusses the implications for developing policy and practices that could lead to improved physical health-care services for people experiencing SMI.

Perceived Barriers to and Facilitators of Engagement in Reverse Integrated Care

“…Moreover, behavioral health consumers' engagement might be impacted by complications of serious and persistent mental illness, such as increases in symptoms, complications of medications, and socioeconomic stressors. 10,11 Results from these interviews with disengaged consumers suggest that additional outreach after prolonged intervals of inactivity might help to re-engage consumers. More research is needed to examine re-engagement strategies for behavioral health consumers accessing integrated primary care and wellness services.…”

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia

“…2,15,95 In light of this, there needs to be more consistency in Australian physical health care of people for a wide spectrum of mental illnesses while retaining a whole-ofperson approach, consistent with the WHO Action Plan. 22 As found in a literature review by Chadwick et al 96 of consumer views on healthcare, numerous barriers mental health consumers face derive from healthcare providers, such as attitudes and organisation of care. As indicated in Table 2, there needs to be much more research into the views of mental health consumers regarding physical health, and genuine direction of reforms based on consumer viewpoints and recommendations.…”

Associations of multiplicity of comorbid health conditions, serious mental illness, and health care costs

“…When medical and psychiatric disorders are not well managed, conditions worsen and health care costs can increase. Furthermore, individuals with SMI face access barriers (e.g., cost) to seeking medical treatment (Chadwick, Street, McAndrew, & Deacon, 2012;Levinson Miller et al, 2003). They often seek services primarily from behavioral health specialists, who typically lack sufficient training to treat medical conditions and contend with time, staffing, and equipment constraints related to assessing for physical health needs (Carney, Allen, & Doebbeling, 2002;Druss et al, 2008;Koyanagi, 2004).…”