Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life

Martens, Nicolaas; Destoop, Marianne; Dom, Geert

doi:10.3390/ijerph18020462

Cited by 11 publications

(11 citation statements)

References 86 publications

(95 reference statements)

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“…Of 4108 articles undergoing title and abstract screening, 389 underwent full‐text review to determine eligibility (Figure 1). A total of 186 systematic reviews were deemed eligible for the scoping review 18–203 . Details of each review are summarized in Table…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of care models for chronic disease management: A scoping review of systematic reviews

Kroenke

Corrigan

Ralston

et al. 2023

PM&R

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ObjectiveTo conduct a scoping review of models of care for chronic disease management to identify potentially effective components for management of chronic traumatic brain injury (TBI).MethodsInformation sources: Systematic searches of three databases (Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews) from January 2010 to May 2021. Eligibility criteria: Systematic reviews and meta‐analyses reporting on the effectiveness of the Chronic Care Model (CCM), collaborative/integrated care, and other chronic disease management models. Data: Target diseases, model components used (n = 11), and six outcomes (disease‐specific, generic health‐related quality of life and functioning, adherence, health knowledge, patient satisfaction, and cost/health care use). Synthesis: Narrative synthesis, including proportion of reviews documenting outcome benefits.ResultsMore than half (55%) of the 186 eligible reviews focused on collaborative/integrated care models, with 25% focusing on CCM and 20% focusing on other chronic disease management models. The most common health conditions were diabetes (n = 22), depression (n = 16), heart disease (n = 12), aging (n = 11), and kidney disease (n = 8). Other single medical conditions were the focus of 22 reviews, multiple medical conditions of 59 reviews, and other or mixed mental health/behavioral conditions of 20 reviews. Some type of quality rating for individual studies was conducted in 126 (68%) of the reviews. Of reviews that assessed particular outcomes, 80% reported disease‐specific benefits, and 57% to 72% reported benefits for the other five types of outcomes. Outcomes did not differ by the model category, number or type of components, or target disease.ConclusionsAlthough there is a paucity of evidence for TBI per se, care model components proven effective for other chronic diseases may be adaptable for chronic TBI care.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of care models for chronic disease management: A scoping review of systematic reviews

Kroenke

Corrigan

Ralston

et al. 2023

PM&R

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“…Emerging evidence shows that well-integrated care can improve the quality of health care and several patient outcomes (23)(24)(25). Therefore, healthcare professionals should take a holistic approach to health care for the benefit of the patient (26,27), and all of the above mentioned barriers to somatic health care should be tackled with this basic idea in mind.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

et al. 2022

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BackgroundA huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access, utilisation, and provision contribute to these poor physical health outcomes.MethodsA qualitative study, using semi-structured interviews, was set up to explore SMI patients' and healthcare professionals' perspectives on somatic health care in different psychiatric settings of the three Belgian regions (Flanders, Brussels, Wallonia). Interviews were digitally recorded and transcribed prior to qualitative inductive thematic analysis, using Nvivo software. The COnsolidated criteria for REporting Qualitative research (COREQ) were used for reporting methods and findings.ResultsCollaboration and information flows between psychiatric healthcare professionals, non-psychiatric healthcare professionals, and persons with SMI were troublesome. This seemed to be mainly due to stigma and prejudice and challenging communication and data transfer. Lack of sufficient training and experience to identify and treat somatic health problems in people with SMI (for psychiatrists and psychiatric nurses) and lack of psychiatric knowledge and feeling or sensitivity for psychiatric patients (for non-psychiatric healthcare professionals) further complicated adequate somatic health care. Finally, optimal somatic follow-up of patients with SMI was hampered by organisational problems (unavailability of equipment, unadapted infrastructure, understaffing, hospital pharmacy issues, and insufficient health promotion/lifestyle interventions), patient-related issues (unawareness of physical problems, non-adherence, need for accompaniment) and financial barriers.ConclusionThere is an urgent need for integrated somatic and mental healthcare systems and a cultural change. Psychiatrists and primary care providers continue to consider the mental and physical health of their patients as mutually exclusive responsibilities due to a lack of sufficient training and experience, poor or absent liaison links, time constraints and organisational and financial barriers. Modifying these aspects will improve the quality of somatic health care for these vulnerable patients.

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“…Such integrated models of primary medical care for individuals with SMI increase the likelihood of GP treatment and use of preventive measures [ 60 ]. A more integrated approach appears to have positive effects on health outcomes, patient satisfaction and health-related quality of life; the use of peer-interventions could improve health service utilization [ 61 , 62 ]. The positive predictive power of physical health status for job retention underscores the role of integrated care for individuals with SMI including mental health, psychosocial and somatic care measures.…”

Section: Discussionmentioning

confidence: 99%

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

Gühne

Pabst

Kösters

et al. 2022

J Occup Med Toxicol

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Background Employment is of great importance as it is associated with various positive effects. Individuals with severe mental illness (SMI) are often excluded from competitive employment. Current data on employment of individuals with mental illness are rare, and influencing factors are under-researched. The present study examines possible predictors of competitive employment among individuals with SMI. Methods This was a cross-sectional and multicentered study of 300 individuals with SMI aged 18 to 65 years. The following inclusion criteria were used: (I) diagnosis of schizophrenia, schizotypal and delusional disorders (ICD-10 F2x), or affective disorders (ICD-10 F3x), (II) duration of psychiatric illness ≥ 2 years, and (III) substantial impact of illness on social functioning. Participants were interviewed by trained staff using standardised instruments. The relationship between potential predictors (age, sex, education, marital status, living situation, migration background, psychosocial functioning, age at first mental problem, physical illness, work ability) and employment was analysed using a hierarchic binary logistic regression model. Results Only one-third (34%) of participants were competitively employed. Almost one-third were unemployed (30%), and 28% reported early retirement due to mental illness. Psychosocial functioning was positively associated with competitive employment (OR = 1.09, 95% CI: 1.05 – 1.13, p < 0.001); concurrent chronic physical illness was negatively associated with competitive employment (OR = 0.38, 95% CI: 0.21 – 0.71, p = 0.002). Conclusions Findings confirm a high risk of exclusion from competitive employment among individuals with SMI. Nonetheless, a substantial proportion of individuals are employed. Findings call for efforts to maintain or enhance workforce participation among individuals with SMI. A special focus should be placed on improving physical health and strengthening psychosocial functioning. Trial registration The study was registered in the German Clinical Trials Register (DRKS) under the registration number DRKS00015801 before the start of recruitment (Registration date: 21.02.2019).

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Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life

Cited by 11 publications

References 86 publications

Effectiveness of care models for chronic disease management: A scoping review of systematic reviews

Effectiveness of care models for chronic disease management: A scoping review of systematic reviews

Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives

Predictors of competitive employment in individuals with severe mental illness: results from an observational, cross-sectional study in Germany

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