scholarly journals Why Do People with Severe Mental Illness Have Poor Cardiovascular Health?—The Need for Implementing a Recovery-Based Self-Management Approach

2021 ◽  
Vol 18 (23) ◽  
pp. 12556
Author(s):  
Sara Zabeen ◽  
Sharon Lawn ◽  
Anthony Venning ◽  
Kate Fairweather
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cardiovascular Health ◽  
Complex Problem ◽  
Self Management ◽  
Management Approach ◽  
Related Factors ◽  
Health And Social Care ◽  
Recovery Models ◽  
New Framework

People with severe mental illness (SMI) die significantly earlier than their well counterparts, mainly due to preventable chronic conditions such as cardiovascular disease (CVD). Based on the existing research, this perspective paper summarises the key contributors to CVD in people with SMI to better target the areas that require more attention to reduce, and ultimately resolve this health inequity. We discuss five broad factors that, according to current international evidence, are believed to be implicated in the development and maintenance of CVD in people with SMI: (1) bio-psychological and lifestyle-related factors; (2) socio-environmental factors; (3) health system-related factors; (4) service culture and practice-related factors; and (5) research-related gaps on how to improve the cardiovascular health of those with SMI. This perspective paper identifies that CVD in people with SMI is a multi-faceted problem involving a range of risk factors. Furthermore, existing chronic care or clinical recovery models alone are insufficient to address this complex problem, and none of these models have identified the significant roles that family caregivers play in improving a person’s self-management behaviours. A new framework is proposed to resolve this complex health issue that warrants a collaborative approach within and between different health and social care sectors.

scholarly journals Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre–post-analysis of the Illness Management and Recovery Programme

2021 ◽  
Author(s):  
Titus A. A. Beentjes ◽  
Steven Teerenstra ◽  
Hester Vermeulen ◽  
Peter J. J. Goossens ◽  
Maria W. G. Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Minimal Important Difference ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Illness Management ◽  
Meaningful Change ◽  
Illness Management And Recovery ◽  
Patient Reported

Abstract Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.

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

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
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.

scholarly journals Self-management interventions for type 2 diabetes in adult people with severe mental illness

2014 ◽  
Author(s):  
Hayley McBain ◽  
Kathleen Mulligan ◽  
Mark Haddad ◽  
Chris Flood ◽  
Julia Jones ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Self Management ◽  
Management Interventions

scholarly journals Experiences of barriers to trans-sectoral treatment of patients with severe mental illness. A qualitative study.

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Annette Sofie Davidsen ◽  
Johan Davidsen ◽  
Alexandra Brandt Ryborg Jønsson ◽  
Maria Haahr Nielsen ◽  
Pia Kürstein Kjellberg ◽  
...  
Keyword(s):  
Mental Illness ◽  
General Practice ◽  
Severe Mental Illness ◽  
Organizational Support ◽  
Interpretative Phenomenological Analysis ◽  
Symptom Control ◽  
Social Psychiatry ◽  
Treatment Team ◽  
Existential Approach ◽  
Health And Social Care

Abstract Background Patients with severe mental illness (SMI) have shorter life expectancy than people without SMI, mainly due to overmortality from physical diseases. They are treated by professionals in three different health and social care sectors with sparse collaboration between them, hampering coherent treatment. Previous studies have shown difficulties involved in establishing such collaboration. As the preparatory phase of an intervention to improve physical health of people with SMI and increase collaboration across sector borders, we explored different actors’ experiences of barriers for collaboration. Method We collected qualitative data from patients, professionals in general practice, psychiatry and social psychiatry involved in the treatment of these patients. Data consisted of notes from meetings and observations, interviews, focus groups and workshops. Analysis was by Interpretative Phenomenological Analysis. Results The study revealed many obstacles to collaboration and coherent treatment, including the consultation structures in general practice, sectors being subject to different legislation, and incompatible IT systems. Professionals in general practice and social psychiatry felt that they were left with the responsibility for actions taken by hospital psychiatry without opportunity to discuss their concerns with psychiatrists. There were also cultural differences between health care and social psychiatry, expressed in ideology and language. Social psychiatry had an existential approach to recovery, whereas the views of health professionals were linked to symptom control and based on outcomes. Meanwhile, patients were left in limbo between these separate ideologies with no leadership in place to promote dialogue and integrate treatments between the sectors. Conclusion Many obstacles to integrated trans-sectoral treatment of patients with SMI seem related to a lack of an overriding leadership and organizational support to establish collaboration and remove barriers related to legislation and IT. However, professional and ideological barriers also contribute. Psychiatry does not consider general practice to be part of the treatment team although general practitioners are left with responsibility for decisions taken in psychiatry; and different ideologies and treatment principles in psychiatry and municipal social psychiatry hamper the dialogue between them. There is a need to rethink the organization to avoid that the three sectors live autonomous lives with different cultures and lack of collaboration.

Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research

2019 ◽  
Vol 26 (5) ◽  
pp. 464-482 ◽  
Author(s):  
Titus A. A. Beentjes ◽  
Betsie G. I. van Gaal ◽  
Theo van Achterberg ◽  
Peter J. J. Goossens
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Essential Element ◽  
Self Management ◽  
Support Needs ◽  
Management Support ◽  
Thematic Synthesis ◽  
Management Interventions ◽  
Important Others

BACKGROUND: The development of de-hospitalization policies in mental health has resulted in a growing emphasis on self-management. In the chronic care model, self-management support is an essential element. Because of the episodic nature of severe mental illness (SMI) and its high relapse rates, we assume that the extent of self-management support needs of individuals with an SMI is considerable. However, a clear overview of the nature of the self-management support needs of persons with SMI is missing. AIMS: This study aimed to identify self-management support needs from the perspective of individuals with SMI. METHOD: A systematic review was conducted using the method of thematic synthesis of qualitative studies. After searching the databases MEDLINE, PsycINFO, CINAHL, and EMBASE, we screened the papers for the eligibility criteria: individuals with an SMI, adequately representing the voice of persons with SMI and describing their self-management support needs. Thirty-one papers were included. RESULTS: The main findings showed that participants in the studies described the need for informational support, emotional support, acknowledgment, encouragement, and guidance to make sense of their illness experiences, ease suffering, obtain validation and recognition, execute self-management tasks, and be led through unfamiliar territory. CONCLUSION: The perspectives of persons with SMI can provide a road map for constructing a self-management support intervention for persons with SMI. Important others have an essential role in fulfilling support needs. Independently managing an SMI is difficult. Therefore, it is preferable to let important others participate in self-management interventions and to introduce peer support.

Sign in / Sign up

Export Citation Format

Share Document