scholarly journals Assessing the physical healthcare gap among patients with severe mental illness: large real-world investigation from Italy

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Giovanni Corrao ◽  
Matteo Monzio Compagnoni ◽  
Valeria Valsassina ◽  
Antonio Lora
Keyword(s):  
Blood Pressure ◽  
Mental Illness ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
National Health System ◽  
Healthcare Utilisation ◽  
Population Based ◽  
Lipid Lowering ◽  
Study Cohort ◽  
Reference Cohort

Background One critical barrier to the uptake of mental health programmes is the so-called physical healthcare gap, a concern raised by the unattended physical comorbidity and early mortality of persons with severe mental illness. Aims To evaluate the extension of physical healthcare gap among persons with severe mental illness under chronic drug therapies. Method A population-based cohort study was carried out, using Lombardy healthcare utilisation databases. Prevalent patients treated with blood pressure-, lipid- or glucose-lowering agents were identified in January 2017. Among these, those who were receiving care for depression, schizophrenia, bipolar disorder or personality disorder formed the study cohort. A reference cohort was randomly selected from prevalent patients treated with chronic therapies without signs of severe mental disorders, to be matched with study cohort members for gender, age and number of previous contacts with the National Health System. One-year adherence to healthcare was measured through the proportion of days covered (drug adherence), and exposure to selected recommendations (clinical control adherence). Results The 55 162 patients with severe mental illness were less likely to have high adherence to blood pressure-lowering, lipid-lowering or antidiabetic agents than the reference cohort by −24% (95% CI −26 to −22%), −10% (95% CI −14 to −6%) and −25% (95% CI −29 to −21%), respectively. The 9250 patients with diabetes and severe mental illness had −18% (95% CI −22% to −13%) reduced likelihood to meet recommendations for the clinical management of diabetes, compared with the reference cohort. Conclusions Adherence to chronic drug therapies was sensibly worse among patients living with mental illness than those without signs of mental disorders.

Stigma and its impact on help-seeking for mental disorders: what do we know?

2008 ◽  
Vol 17 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Georg Schomerus ◽  
Matthias C. Angermeyer
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Help Seeking ◽  
Public Attitudes ◽  
Population Based ◽  
Professional Help ◽  
Promising Target ◽  
Individual Discrimination ◽  
Stigma Of Mental Illness ◽  
Seeking Help

SummaryAims – Many people suffering from serious mental illness do not seek appropriate medical help. The stigma of mental illness has often been considered a potential cause for reluctance in seeking help. We review recent evidence on this topic. Methods – Narrative review of the recent literature on stigma and helpseeking for psychiatric disorders. Results – There is proof of a particular stigma attached to seeking help for a mental problem. Anticipated individual discrimination and discrimination qua self-stigmatisation are associated with a reduced readiness to seek professional help for mental disorders. Intervention studies show that destigmatisation may lead to increased readiness to seek professional help, but other aspects like knowledge about mental diseases seem to be at least as important. The belief that seeking help for a mental health problem is actually helpful has been shown to be at the core of help-seeking intentions and thus offers a promising target for information programmes. Population based time-trend studies show that public attitudes towards help-seeking have improved over the last decade. Discussion – The relationship between help-seeking intentions and actual help-seeking needs further exploration. While many studies have been able to relate attitudes to intentions, predicting actual help-seeking has proved more difficult.Declaration of Interest: None.

Impact of severe mental illness on cancer stage at diagnosis and subsequent mortality: A population-based register study

2018 ◽  
Vol 201 ◽  
pp. 62-69 ◽  
Author(s):  
A. Toender ◽  
T. Munk-Olsen ◽  
M. Vestergaard ◽  
J.T. Larsen ◽  
N.P. Suppli ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Population Based ◽  
Register Study ◽  
Cancer Stage ◽  
Stage At Diagnosis

Police Violence among Adults Diagnosed with Mental Disorders

2020 ◽  
Vol 45 (2) ◽  
pp. 81-89
Author(s):  
Hyun-Jin Jun ◽  
Jordan E DeVylder ◽  
Lisa Fedina
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Population ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
Violence Exposure ◽  
Health Conditions ◽  
Psychotic Symptoms ◽  
Police Violence ◽  
Mental Health Conditions

Abstract Police violence is reportedly common among those diagnosed with mental disorders characterized by the presence of psychotic symptoms or pronounced emotional lability. Despite the perception that people with mental illness are disproportionately mistreated by the police, there is relatively little empirical research on this topic. A cross-sectional general population survey was administered online in 2017 to 1,000 adults in two eastern U.S. cities to examine the relationship between police violence exposure, mental disorders, and crime involvement. Results from hierarchical logistic regression and mediation analyses revealed that a range of mental health conditions are broadly associated with elevated risk for police violence exposure. Individuals with severe mental illness are more likely than the general population to be physically victimized by police, regardless of their involvement in criminal activities. Most of the excess risk of police violence exposure related to common psychiatric diagnoses was explained by confounding factors including crime involvement. However, crime involvement may necessitate more police contact, but does not necessarily justify victimization or excessive force (particularly sexual and psychological violence). Findings support the need for adequate training for police officers on how to safely interact with people with mental health conditions, particularly severe mental illness.

scholarly journals Delays to diagnosis among people with severe mental illness in rural Vietnam, a population-based cross-sectional survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trang Nguyen ◽  
Thach Tran ◽  
Sally Green ◽  
Arthur Hsueh ◽  
Tuan Tran ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Financial Burden ◽  
National Policy ◽  
Mental Health Program ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background People with severe mental illness (SMI) living in low and middle-income countries can experience extended delays to diagnosis, which hinder access to medical treatment. The aims of this study were to describe the interval to diagnosis among these people in rural Vietnam and its associated factors. Methods A population-based cross-sectional study was conducted among people with SMI in two provinces in Vietnam. The delay to diagnosis was defined as the time between the first abnormal behaviour being observed by family members and the formal diagnosis of psychosis. A multilevel linear regression was used to examine the factors associated with the delay to diagnosis. Results Among 404 people with SMI from 370 households, the median delay to diagnosis was 11.5 months (IQR 0–168.0). Overall, 53.7% had a delay to diagnosis of less than one year (95% CI: 48.81–58.54). The financial burden of these people on their families was nearly USD 470/year. After adjusting for other factors at individual and household levels, living in a Northern province; older age, and having psychotic diagnosis before the implementation of the National Community Mental Health program (2003) were associated with a delay of more than twelve months to diagnosis. Conclusions These data indicate that the implementation of a national policy for community-based care has been effective in reducing the delay to diagnosis in rural Vietnam. Therefore, there is a need for strengthening the program and mental health policies, focusing on public communication to improve mental health literacy and reduce stigma against SMI.

scholarly journals An Overview of Cognitive Remediation Therapy for People with Severe Mental Illness

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cherrie Galletly ◽  
Ashlee Rigby
Keyword(s):  
Mental Illness ◽  
Cognitive Function ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
Cognitive Deficits ◽  
Cognitive Remediation ◽  
Mental Illnesses ◽  
Cognitive Remediation Therapy ◽  
Severe Mental Disorders ◽  
Varying Length

Cognitive remediation refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders. Cognitive remediation therapy (CRT) can be delivered via computerised programs, of varying length and complexity, or can be undertaken one-on-one by a trained clinician. There has been a considerable interest in cognitive remediation, driven by recognition that cognitive deficits are a major determinant of outcome in people with severe, chronic mental illnesses. CRT has been shown to be effective, especially if combined with vocational rehabilitation.

Monitoring cardiovascular disease risk in individuals with severe mental illness in an inpatient mental health setting: a secondary data analysis

2020 ◽  
Vol 15 (11) ◽  
pp. 1-15
Author(s):  
Herbert P Mwebe ◽  
Margaret Volante ◽  
Tim Weaver
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Mental Illness ◽  
Blood Glucose ◽  
Severe Mental Illness ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Electronic Records

Background/Aims Life expectancy in people with lived experience of mental health conditions is reduced by up to 25 years; this is from preventable physical medical comorbidities and multi-morbidities such as cardiovascular disease, diabetes, cancers and smoking-related lung disease. Two-thirds of these deaths are avoidable if people with severe mental illness are offered prompt physical screening checks and monitoring. The aim of this article was to explore barriers to the management of cardiovascular disease risk on inpatient wards and make recommendations in relation to cardiovascular disease risk management in people with severe mental illness. Methods A structured MS Excel extraction data tool informed by best practice guidance was developed and used to extract electronic patient data on screening and monitoring of cardiovascular disease risk factors (blood pressure, smoking, alcohol, lipids, body mass index/weight, blood glucose level) across 10 inpatient psychiatric wards within one London mental health trust. A target sample of 245 electronic records of patients with severe mental illness discharged between 25 August 2018 and 13 February 2019 with length of inpatient stay >40 days was examined. Simple random sampling (MS Excel random number generator) was used to select a final sample of 120 electronic records. All the included samples had been prescribed psychotropic medication. Results Regarding patient demographics, there was an inverse correlation with age, with a greater proportion of inpatients being of a younger age: 51% aged 18–39 years compared with 14% aged 60–79 years. The study found an average of 71% compliance of the documentation of data on all individual parameters (smoking, alcohol, body mass index, blood pressure, serum glucose, serum lipids, electrocardiogram) at baseline. Results showed an average of 79% compliance for monitoring review at least once across the parameters within 3 months of admission. Conclusions It is recommended as a minimum for individuals with severe mental illness under the care of mental health services and/or taking psychotropic medication to have regular cardiometabolic risk assessment and management of risk at the point of entry into services and a review for weight, waist circumference, blood glucose checks, lipid profile, blood pressure, lifestyle choice behaviours and personal assessment of cardiovascular disease. Although progress is being made across provider services to implement the above, gaps in practice are still evident, as demonstrated in these findings.

scholarly journals Temporal order of cancers and mental disorders in an adult population

BJPsych Open ◽  
2018 ◽  
Vol 4 (3) ◽  
pp. 95-105 ◽  
Author(s):  
David Cawthorpe ◽  
Marc Kerba ◽  
Aru Narendran ◽  
Harleen Ghuttora ◽  
Gabrielle Chartier ◽  
...  
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Temporal Order ◽  
Adult Population ◽  
Full Range ◽  
Population Level ◽  
Population Based ◽  
Disease Mechanism ◽  
Physician Billing

BackgroundPopulation-based examination of comorbidity is an emerging field of study.AimsThe purpose of the present population level study is to expand our understanding of how cancer and mental illness are temporally associated.MethodA sample of 83 648 056 physician billing records for 664 838 (56% female) unique individuals over the age of 18 was stratified on ages 19–49 years and 50+ years, with temporal order of mental disorder and cancer forming the basis of comparison.ResultsMental disorders preceded cancers for both genders within each age strata. The full range of cancers and mental disorders preceding or following each pivot ICD class are described in terms of frequency of diagnosis and duration in days, with specific examples illustrated.ConclusionsThe temporal comorbidity between specific cancers and mental disorders may be useful in screening or clinical planning and may represent indicators of disease mechanism that warrant further screening or investigation.Declaration of interestNone.

Monitoring cardiovascular disease risk in individuals with severe mental illness in an inpatient mental health setting: a secondary data analysis

2020 ◽  
Vol 9 (3) ◽  
pp. 1-14
Author(s):  
Herbert P Mwebe ◽  
Margaret Volante ◽  
Tim Weaver
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Mental Illness ◽  
Blood Glucose ◽  
Severe Mental Illness ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Electronic Records

Background/Aims Life expectancy in people with lived experience of mental health conditions is reduced by up to 25 years; this is from preventable physical medical comorbidities and multi-morbidities such as cardiovascular disease, diabetes, cancers and smoking-related lung disease. Two-thirds of these deaths are avoidable if people with severe mental illness are offered prompt physical screening checks and monitoring. The aim of this article was to explore barriers to the management of cardiovascular disease risk on inpatient wards and make recommendations in relation to cardiovascular disease risk management in people with severe mental illness. Methods A structured MS Excel extraction data tool informed by best practice guidance was developed and used to extract electronic patient data on screening and monitoring of cardiovascular disease risk factors (blood pressure, smoking, alcohol, lipids, body mass index/weight, blood glucose level) across 10 inpatient psychiatric wards within one London mental health trust. A target sample of 245 electronic records of patients with severe mental illness discharged between 25 August 2018 and 13 February 2019 with length of inpatient stay >40 days was examined. Simple random sampling (MS Excel random number generator) was used to select a final sample of 120 electronic records. All the included samples had been prescribed psychotropic medication. Results Regarding patient demographics, there was an inverse correlation with age, with a greater proportion of inpatients being of a younger age: 51% aged 18–39 years compared with 14% aged 60–79 years. The study found an average of 71% compliance of the documentation of data on all individual parameters (smoking, alcohol, body mass index, blood pressure, serum glucose, serum lipids, electrocardiogram) at baseline. Results showed an average of 79% compliance for monitoring review at least once across the parameters within 3 months of admission. Conclusions It is recommended as a minimum for individuals with severe mental illness under the care of mental health services and/or taking psychotropic medication to have regular cardiometabolic risk assessment and management of risk at the point of entry into services and a review for weight, waist circumference, blood glucose checks, lipid profile, blood pressure, lifestyle choice behaviours and personal assessment of cardiovascular disease. Although progress is being made across provider services to implement the above, gaps in practice are still evident, as demonstrated in these findings.

scholarly journals Thirty-Day Mortality After Infection Among Persons With Severe Mental Illness: A Population-Based Cohort Study in Denmark

2015 ◽  
Vol 172 (8) ◽  
pp. 776-783 ◽  
Author(s):  
Anette Riisgaard Ribe ◽  
Mogens Vestergaard ◽  
Wayne Katon ◽  
Morten Charles ◽  
Michael Eriksen Benros ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cohort Study ◽  
Severe Mental Illness ◽  
Population Based
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