Receipt of Clinical Preventive Medical Services Among Psychiatric Patients

Abstract

A total of 267 patients who were receiving care for psychiatric and substance use disorders at a university medical center completed a self-report instrument assessing their previous receipt of clinical preventive services. High rates of mammography and Pap tests within the past year were observed (76 and 77 percent). Rates of immunization (hepatitis B and tetanus vaccines) varied from 11 percent to 78 percent. Rates of preventive counseling for sexual practices, diet, and avoidance of alcohol were lower than 25 percent in all groups. Only 6 percent of all patients reported having been screened for gun ownership, despite the high risk of suicide among gun owners.

Care Provision to Prevent Chronic Disease by Community Mental Health Clinicians

“…[16][17][18][19][20]23,25,27 Similarly, the low rates of referral are consistent with previous findings regarding smoking-cessation care 20,24,26 and care for nutrition 52 in these settings. The latter findings contrast with the particular importance of referral and follow-up care in ensuring successful change in health risk behaviors.…”

“…For example, estimates of the prevalence of assessment of health risk behaviors by medical and nursing staff have ranged from 5% to 19%. 16 With regard to the provision of brief advice, estimates have ranged from 4% to 42%, [17][18][19] suggesting suboptimal care provision for these care elements. Similarly, in a recent Australian survey of service managers of all community mental health services in the state of New South Wales (NSW), Australia, 20 only 14% reported providing "most" smokers with referral to a free, government-funded telephone cessation service.…”

“…Similarly, in a recent Australian survey of service managers of all community mental health services in the state of New South Wales (NSW), Australia, 20 only 14% reported providing "most" smokers with referral to a free, government-funded telephone cessation service. The majority of such studies have focused on either the provision of smoking-cessation care, [20][21][22][23][24][25][26] care provision by a single type of provider, 18,19,27 or provision of single elements of preventive care (either assessment, advice, or referral/follow-up), [16][17][18]27 with no study reporting the prevalence of all such preventive care elements for multiple health risk behaviors.…”

Reproductive Health in Women with Serious Mental Illnesses: A Review

“…Eighteen (23%) studies from the subtotal 78 were focused on five distinct measures of RH risky behaviors: more lifetime sex partners [26,57], unsafe sex [13, 14, 23, 26, 30, 57-59, 61, 79], low usage of contraception [14,23,26], risky behaviors for cervical and breast cancer [6,20,26,58,79], and consumption of psychotropic agent(s) during the pregnancy and breastfeeding [12,19,35,48,71]. The lack of awareness in RH as a determinant for risky behaviors, in particular, lack of knowledge and attitudes that could prevent unwanted pregnancies, sexually transmitted infections, female cancer, and other RH outcomes among women with SMI, was assessed only in seven (10.2%) studies: [11,26,46,55,[57][58][59]72] (Table 1). Thirty-one (39.7%) studies captured four primary dimensions of the sample (age, gender, marital status, and psychiatric condition) [7, 9-14, 20-24, 26, 29, 32, 39, 40, 45, 47-49, 51, 54, 57-59, 65, 67, 70, 71, 73].…”

“…Synthetic estrogen and progestins may influence depressive and physical symptoms in depressed women [4,43,60,72,81]. Research suggests that women with major depression, schizophrenia, bipolar disorder, and cognitive impairment may be at increased risk for breast and cervical cancer [6,9,11,20,25,40,56,58]. They may represent a group with barriers to obtaining breast and cervical screening, including national screening programs [71,79].…”