Prevalence and correlates of food insecurity in community-based individuals with severe mental illness receiving long-acting injectable antipsychotic treatment

2020 ◽  
Vol 124 (4) ◽  
pp. 470-477
Author(s):  
Scott B. Teasdale ◽  
Rachel Morell ◽  
Julia M. Lappin ◽  
Jackie Curtis ◽  
Andrew Watkins ◽  
...  
Keyword(s):  
Mental Illness ◽  
Food Insecurity ◽  
Severe Mental Illness ◽  
Communicable Disease ◽  
Vigorous Physical Activity ◽  
Lifestyle Factors ◽  
Community Services ◽  
Antipsychotic Treatment ◽  
Cross Sectional ◽  
Long Acting

AbstractPeople with severe mental illness (SMI) have numerous risk factors that may predispose them to food insecurity (FI); however, the prevalence of FI and its effects on health are under-researched in this population. The present study aimed to describe the prevalence of FI and its relationship to lifestyle factors in people with SMI. This cross-sectional study recruited people with SMI receiving long-acting injectable (LAI) antipsychotic medication from community services at three sites in Sydney, Australia. Assessments were completed on physical health and lifestyle factors. χ2 Tests, independent-samples t tests and binary logistic regression analyses were calculated to examine relationships between lifestyle factors and FI. In total, 233 people completed the assessments: 154 were males (66 %), mean age 44·8 (sd 12·7) years, and the majority (70 %) had a diagnosis of schizophrenia. FI was present in 104 participants (45 %). People with FI were less likely to consume fruits (OR 0·42, 95 % CI 0·24, 0·74, P = 0·003), vegetables (OR 0·39, 95 % CI 0·22, 0·69, P = 0·001) and protein-based foods (OR 0·45, 95 % CI 0·25, 0·83, P = 0·011) at least once daily, engaged in less moderate to vigorous physical activity (min) (OR 0·997, 95 % CI 0·993, 1·000, P = 0·044), and were more likely to smoke (OR 1·89, 95 % CI 1·08, 3·32, P = 0·026). FI is highly prevalent among people with SMI receiving LAI antipsychotic medications. Food-insecure people with SMI engage in less healthy lifestyle behaviours, increasing the risk of future non-communicable disease.

Social stigma in severe mental illness in Tunisia: Clinical and socio-demographic correlates

2017 ◽  
Vol 41 (S1) ◽  
pp. S577-S577 ◽  
Author(s):  
U. Ouali ◽  
R. Jomli ◽  
R. Nefzi ◽  
H. Ouertani ◽  
F. Nacef
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cultural Context ◽  
Social Inclusion ◽  
Psychiatric Patients ◽  
Social Stigma ◽  
Cross Sectional Study ◽  
Local Context ◽  
Cross Sectional ◽  
Competing Interest

IntroductionMental patients generally internalize some of the negative conceptions about how most people view them: they might be considered incompetent or untrustworthy or believe that people would not want to hire, or marry someone with mental illness. A lot of research on stigma has been conducted in western countries; however, little is still known on the situation in Arab-Muslim societies.ObjectivesTo evaluate social stigma as viewed by patients suffering from severe mental illness (SMI)MethodsThis is a cross-sectional study on clinically stabilized patients with schizophrenia and Bipolar Disorder (BD) according to DSM IV, who were interviewed in our out-patients clinic with the help of a semi-structured questionnaire, containing 8 opinions on the social inclusion and stigmatization of psychiatric patients, with special reference to the local cultural context (e.g.: “It is better to hide mental illness in order to preserve the reputation of my family”)ResultsWe included 104 patients, 51% with schizophrenia and 49% with BD. Mean age was 38.4 years (18–74 years); 59.6% were males. Overall social stigma scores were high. Social stigma in patients was correlated with gender, age, place of residence and diagnosis. Patients with BD showed significantly less social stigma than patients with schizophrenia.ConclusionOur results show the need for a better understanding of this phenomenon in patients with SMI, but also within Tunisian society, in order to elaborate anti stigma strategies adapted to the local context.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Study on covert administration of medications practices among persons with severe mental illness: A cross-sectional study

2021 ◽  
pp. 002076402110656
Author(s):  
Prakyath R Hegde ◽  
Guru S Gowda ◽  
Bhavika Vajawat ◽  
Vinay Basavaraju ◽  
Sydney Moirangthem ◽  
...  
Keyword(s):  
Mental Illness ◽  
Family Functioning ◽  
Severe Mental Illness ◽  
Self Care ◽  
Male Gender ◽  
Poor Adherence ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Medication Delivery ◽  
Delivery Practices

Background: Covert administration of medication (CoAdM) by caregivers to persons with severe mental illness (SMI) is a commonly observed medication delivery practice in India. Aims: This study aims to examine different medication delivery practices adopted by caregivers to provide care to SMI at times of medication refusal. Method: This study was conducted at the outpatient department between April 2019 and November 2019. A semi-structured questionnaire was used to interview the caregivers of persons with SMI to assess medication delivery practices. Results: A total of 300 caregivers were interviewed. CoAdM was practiced in 96 (32.0%) persons with SMI at least once during their lifetime, and other strategies used were pleading ( n = 105, 35.0%), lying ( n = 10, 3.3%), and threatening ( n = 154, 51.4%). Logistic regression showed that male gender (OR 4.75; CI 1.37–16.46), absent insight (OR 10.0; CI 2.01–47.56), and poor adherence to medication (OR 4.75; CI 1.31–16.92) were significantly associated with CoAdM in the last 1 year. Caregivers perceived significant improvement in self-care ( Z = −4.37, p < .01), interpersonal ( Z = −7.61, p < .01), work ( Z = −5.9, p < .01), family functioning ( Z = −7.82, p < .01) difficult behavior ( Z = −8.27, p < .01), and dependency ( Z = −6.34, p < .01) in persons with SMI with use of CoAdM. Conclusions: CoAdM was given to one in three persons with SMI at some point in their lives. Male gender, absent insight and poor adherence were predictive of CoAdM in the last 1 year. Caregiver perceived improvements in self-care, work, interpersonal, family functioning, problem behaviors, and dependency after CoAdM. Policies need to be evolved to serve all stakeholders while keeping these practices in mind.

scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

The future of specialist community teams in the care of those with severe mental illness

2007 ◽  
Vol 16 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Severe Mental Illness ◽  
Community Mental Health Services ◽  
Community Services ◽  
Crisis Resolution ◽  
Crisis Resolution Teams

SummaryAims – Specialist interventions in community psychiatry for severe mental illness are expanding and their place needs to be re-examined. Methods – Recent literature is reviewed to evaluate the advantages and disadvantages of specialist teams. Results – Good community mental health services reduce drop out from care, prevent suicide and unnatural deaths, and reduce admission to hospital. Most of these features have been also demonstrated by assertive community outreach and crisis resolution teams when good community services are not available. In well established community services assertive community teams do not reduce admission but both practitioners and patients prefer this service to other approaches and it leads to better engagement. Crisis resolution teams appear to be more successful than assertive community teams in preventing admission to hospital, although head- to-head comparisons have not yet been made. All specialist teams have the potential of fragmenting services and thereby reducing continuity of care. Conclusions – The assets of improved engagement and greater satisfaction with assertive, crisis resolution and home treatment teams are clear from recent evidence, but to improve integration of services they are probably best incorporated into community mental health services rather than standing alone.Declaration of Interest: The author has been the sole consultant in two assertive outreach teams since 1994 and might there- fore be expected to be in favour of this genre of service. He has received grants for evaluation of different services models from the Department of Health (UK) and the Medical Research Council (UK).

Care coordination as a collaborative element of recovery oriented services for persons with severe mental illness

2021 ◽  
pp. 103985622110373
Author(s):  
Anton N Isaacs
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Community Service ◽  
Care Coordination ◽  
Community Services ◽  
Intersectoral Collaboration ◽  
Coordination Model ◽  
Form Part ◽  
Multiple Health

Objective: To propose a model where care coordination can form part of recovery oriented care when it is included as a collaborative element of services for persons with severe mental illness. Conclusion: A recovery-oriented service requires more than clinical interventions. It also needs to address social determinants and be individualised or person centred. Multiple health and community services need to be involved. A care coordination model is capable of addressing multiple needs. It gives the client the first and foremost voice. It facilitates intersectoral collaboration, reduces the burden on clinical mental health services and is supported by mental health and community service personnel.

Association of socioeconomic and lifestyle factors with chronic non-communicable diseases and multimorbidity among the elderly in rural southwest China

2019 ◽  
Vol 42 (2) ◽  
pp. 239-246 ◽  
Author(s):  
Xiao Li ◽  
Le Cai ◽  
Wen-long Cui ◽  
Xu-ming Wang ◽  
Hui-fang Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Southwest China ◽  
Communicable Disease ◽  
Fasting Blood Glucose ◽  
The Elderly ◽  
Lifestyle Factors ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background This study estimates the prevalence of five chronic non-communicable disease (NCDs) (hypertension, diabetes, CHD, COPD and stroke) and its multimorbidity, and examines the relationship between SES and lifestyle factors and multimorbidity among older adults in rural southwest China. Methods A cross-sectional survey of 4833 consenting adults aged ≥60 years was conducted in 2017. Data on the demographics, smoking, drinking, height, weight, blood pressure and fasting blood glucose were collected. Results Among the participants, the overall prevalence of hypertension, diabetes, stroke, COPD and CHD was 50.6, 10.2, 6.4, 5.4 and 5.5%, respectively, and of multimorbidity was 16.1%. Females had a higher prevalence of hypertension, diabetes and multimorbidity of chronic NCDs, but a lower prevalence of COPD than males (P &lt; 0.05). Older adults with good household assets and access to medical services were less likely to experience multimorbidity, whereas obese and centrally obese participants, current smokers, current drinkers and those with a family history of chronic NCDs had a greater probability of multimorbidity. Conclusions The findings suggest that effective strategies for prevention and control of chronic NCDs and its multimorbidity are urgently needed, especially for low-income, elderly, ethnic minority adults with poor access to medical services.

scholarly journals Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

2020 ◽  
Vol 29 (8) ◽  
pp. 2073-2087 ◽  
Author(s):  
Anne Berghöfer ◽  
Luise Martin ◽  
Sabrina Hense ◽  
Stefan Weinmann ◽  
Stephanie Roll
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Care Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Care Model
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