Practical recommendations for improvement of the physical health care of patients with severe mental illness

Abstract

This article provides a range of policy recommendations that could lead to considerable improvements in the physical health of SMI patients.

Promoting physical health in severe mental illness: patient and staff perspective

“…Staff and patients discussed possibilities of prevention and treatment at different levels, and their suggestions were similar: they both mentioned the need for a less fragmented healthcare system. The need for continuity in treatment and secure relations , along with better cooperation between the primary and secondary sector, is known from previous research . Patients would benefit from an individual case manager who can help them navigate in the healthcare system, help them structure everyday life and help them adhere to doctor appointments and lifestyle changes such as physical activity and healthy food choices.…”

“…Studies of lifestyle interventions have proven them to be effective in patients with schizophrenia; however, long‐term implementation of these interventions into daily clinical practice is still lacking . To understand the physical health problems and causes as well as methods to prevent and treat these issues, the patient's and staff's perceptions are important, as insights on both an individual and system level are gained .…”

Geographical disparities in prescription practices of lithium and clozapine: a community‐based study

“…The potential role of local practice in variations in lithium and clozapine prescribing rates might explain the present findings showing that such variations are chiefly related to primary care resources and coordination between primary and secondary care. The key role of primary care in reducing the mortality and somatic morbidity of these patients is widely acknowledged . In France, GPs are in theory the gatekeepers of psychiatric care.…”

“…There is a consensus about the need to improve and to structure collaboration between mental health services and primary care for patients with severe mental disorders, as informational continuity and feedback from mental health structures to primary care are often deficient . Collaborative care is a promising model of such a structured organization and has been applied mostly for common psychiatric disorders , and to a lesser extent in patients with psychosis or bipolar disorder .…”

Making sense of self‐care practices at the intersection of severe mental illness and physical health—An Australian study

“…The separation of services for mental and physical healthcare is confusing for people who are unclear about which professional they need to consult (van Hasselt, Oud, & Loonen, ). Moreover, even if they do know where to access care, relationships between health professionals and people with SMI are fragile and do not always work out well (van Hasselt et al., ).…”