Quality of life, symptom severity and level of functioning in people with severe mental illness ready for hospital discharge

Abstract Background People with severe mental illness (SMI) have an increased risk of premature mortality, predominantly due to somatic health conditions. Evidence indicates that primary and tertiary prevention and improved treatment of somatic conditions in patients with SMI could reduce this excess mortality. This paper reports a protocol designed to evaluate the feasibility of a coordinated co-produced care program (SOFIA model, a Danish acronym for Severe Mental Illness and Physical Health in General Practice) in the general practice setting to reduce mortality and improve quality of life in patients with severe mental illness. Methods The SOFIA pilot trial is designed as a cluster randomized controlled trial targeting general practices in two regions in Denmark. We aim to include 12 practices, each of which is instructed to recruit up to 15 community-dwelling patients aged 18 and older with SMI. Practices will be randomized by a computer in a ratio of 2:1 to deliver a coordinated care program or usual care during a 6-month study period. A randomized algorithm is used to perform randomization. The coordinated care program includes educational training of general practitioners and their clinical staff educational training of general practitioners and their clinical staff, which covers clinical and diagnostic management and focus on patient-centered care of this patient group, after which general practitioners will provide a prolonged consultation focusing on individual needs and preferences of the patient with SMI and a follow-up plan if indicated. The outcomes will be parameters of the feasibility of the intervention and trial methods and will be assessed quantitatively and qualitatively. Assessments of the outcome parameters will be administered at baseline, throughout, and at end of the study period. Discussion If necessary the intervention will be revised based on results from this study. If delivery of the intervention, either in its current form or after revision, is considered feasible, a future, definitive trial to determine the effectiveness of the intervention in reducing mortality and improving quality of life in patients with SMI can take place. Successful implementation of the intervention would imply preliminary promise for addressing health inequities in patients with SMI. Trial registration The trial was registered in Clinical Trials as of November 5, 2020, with registration number NCT04618250. Protocol version: January 22, 2021; original version

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Is Housing a Predictor of Autonomy and Quality of Life of People with Severe Mental Illness? Implications for Social Work

Australian Social Work ◽

10.1080/0312407x.2018.1498114 ◽

2018 ◽

Vol 71 (4) ◽

pp. 491-506

Author(s):

Tony Welch ◽

Helen Cleak

Keyword(s):

Quality Of Life ◽

Mental Illness ◽

Social Work ◽

Severe Mental Illness

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The influence of social support, care burden, and depression on quality of life among caregivers of patients with severe mental illness: a cross-sectional survey in rural areas of Sichuan, China

The Lancet ◽

10.1016/s0140-6736(19)32348-7 ◽

2019 ◽

Vol 394 ◽

pp. S12

Author(s):

Xiaxia Sun ◽

Jing He ◽

Yan Liu ◽

Jingjing Ge ◽

Wenjie Zhang ◽

...

Keyword(s):

Quality Of Life ◽

Social Support ◽

Mental Illness ◽

Severe Mental Illness ◽

Rural Areas ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Burden

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

Quality of Life Research ◽

10.1007/s11136-020-02470-0 ◽

2020 ◽

Vol 29 (8) ◽

pp. 2073-2087 ◽

Cited By ~ 5

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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Self-management interventions for people with severe mental illness: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.2019.54 ◽

2019 ◽

Vol 214 (5) ◽

pp. 260-268 ◽

Cited By ~ 18

Author(s):

Melanie Lean ◽

Miriam Fornells-Ambrojo ◽

Alyssa Milton ◽

Brynmor Lloyd-Evans ◽

Bronwyn Harrison-Stewart ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Mental Illness ◽

Severe Mental Illness ◽

Meta Analysis ◽

Health Problems ◽

Self Management ◽

Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

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Predictors of quality of life in people with severe mental illness

The British Journal of Psychiatry ◽

10.1192/bjp.175.5.426 ◽

1999 ◽

Vol 175 (5) ◽

pp. 426-432 ◽

Cited By ~ 60

Author(s):

Thomas Fahy ◽

Andy Kent ◽

Theresa Tattan ◽

Elizabeth Van Horn ◽

Ian White

Keyword(s):

Quality Of Life ◽

Mental Illness ◽

Case Management ◽

Severe Mental Illness ◽

Unmet Needs ◽

Subjective Quality ◽

Improve Quality ◽

Subjective Quality Of Life ◽

Clinical Variables

BackgroundIt is not clear which model of case management is most likely to improve quality of life in people with severe mental illness.AimsTo use baseline data derived from the UK700 Case Management Trial to assess the relative importance of clinical, social and unmet needs variables as predictors of subjective quality of life in patients with severe mental illness.MethodPatients (n=708) were assessed on quality of life (Lancashire Quality of Life Profile), needs (Camber well Assessment of Need), psychopathology and social functioning. Variables that were amenable to change through case management were investigated as predictors of quality of life.ResultsSocial variables accounted for 7% of the variance for subjective quality of life, compared with 19% for clinical variables, and 20% for unmet needs. The strongest predictors of subjective quality of life were unmet basic, social and functioning needs, depression and positive psychotic symptoms.ConclusionsSubjective quality of life in severely mentally ill patients is predicted by clinical variables and unmet needs. The results identify priority areas for the attention of case managers who seek to improve quality of life in these patients.

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