Physical health screening for patients with severe mental illness

2016 ◽  
Vol 20 (1) ◽  
pp. 21-25
Author(s):  
Tonsha Emerson ◽  
Kimberly Williams ◽  
Maxie Gordon
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Health Screening ◽  
Physical Health Screening

scholarly journals Interventions to increase access to or uptake of physical health screening in people with severe mental illness: a realist review

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019412 ◽  
Author(s):  
Frédérique Lamontagne-Godwin ◽  
Caroline Burgess ◽  
Sarah Clement ◽  
Melanie Gasston-Hales ◽  
Carolynn Greene ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Quality Improvement ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Effect Size ◽  
Realist Review ◽  
Health Screening ◽  
Feasibility Trial ◽  
Physical Health Screening

ObjectivesTo identify and evaluate interventions aimed at increasing uptake of, or access to, physical health screening by adults with severe mental illness; to examine why interventions might work.DesignRealist review.SettingPrimary, secondary and tertiary care.ResultsA systematic search identified 1448 studies, of which 22 met the inclusion criteria. Studies were from Australia (n=3), Canada (n=1), Hong Kong (n=1), UK (n=11) and USA (n=6). The studies focused on breast cancer screening, infection preventive services and metabolic syndrome (MS) screening by targeting MS-related risk factors. The interventions could be divided into those focusing on (1) health service delivery changes (12 studies), using quality improvement, randomised controlled trial, cluster randomised feasibility trial, retrospective audit, cross-sectional study and satisfaction survey designs and (2) tests of tools designed to facilitate screening (10 studies) using consecutive case series, quality improvement, retrospective evaluation and pre–post audit study designs. All studies reported improved uptake of screening, or that patients had received screening they would not have had without the intervention. No estimation of overall effect size was possible due to heterogeneity in study design and quality. The following factors may contribute to intervention success: staff and stakeholder involvement in screening, staff flexibility when taking physical measurements (eg, using adapted equipment), strong links with primary care and having a pharmacist on the ward.ConclusionsA range of interventions may be effective, but better quality research is needed to determine any effect size. Researchers should consider how interventions may work when designing and testing them in order to target better the specific needs of this population in the most appropriate setting. Behaviour-change interventions to reduce identified barriers of patient and health professional resistance to screening this population are required. Resource constraints, clarity over professional roles and better coordination with primary care need to be addressed.

scholarly journals Systematic computerised cardiovascular health screening for people with severe mental illness

2014 ◽  
Vol 38 (6) ◽  
pp. 280-284 ◽  
Author(s):  
David Yeomans ◽  
Kate Dale ◽  
Kate Beedle
Keyword(s):  
Mental Illness ◽  
Cardiovascular Risk ◽  
Information Systems ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Cardiovascular Health ◽  
Significant Proportion ◽  
Clinical Information ◽  
Health Screening ◽  
Physical Health Screening

Aims and methodPeople with severe mental illness (SMI) die relatively young, with mortality rates four times higher than average, mainly from natural causes, including heart disease. We developed a computer-based physical health screening template for use with primary care information systems and evaluated its introduction across a whole city against standards recommended by the National Institute for Health and Care Excellence for physical health and cardiovascular risk screening.ResultsA significant proportion of SMI patients were excluded from the SMI register and only a third of people on the register had an annual physical health check recorded. The screening template was taken up by 75% of GP practices and was associated with better quality screening than usual care, doubling the rate of cardiovascular risk recording and the early detection of high cardiovascular risk.Clinical implicationsA computerised annual physical health screening template can be introduced to clinical information systems to improve quality of care.

Towards holistic dual diagnosis care: physical health screening in a Victorian community-based alcohol and drug treatment service

2016 ◽  
Vol 22 (2) ◽  
pp. 81 ◽  
Author(s):  
Lara Jackson ◽  
Boyce Felstead ◽  
Jahar Bhowmik ◽  
Rachel Avery ◽  
Rhonda Nelson-Hearity
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Outcomes ◽  
Physical Health ◽  
Dual Diagnosis ◽  
Health Screening ◽  
Community Based ◽  
People With Mental Illness ◽  
Mental Health Clients ◽  
Physical Health Screening

The poorer health outcomes experienced by people with mental illness have led to new directions in policy for routine physical health screening of service users. By contrast, little attention has been paid to the physical health needs of consumers of alcohol and other drug (AOD) services, despite a similar disparity in physical health outcomes compared with the general population. The majority of people with problematic AOD use have comorbid mental illness, known as a dual diagnosis, likely to exacerbate their vulnerability to poor physical health. With the potential for physical health screening to improve health outcomes for AOD clients, a need exists for systematic identification and management of common health conditions. Within the current health service system, those with a dual diagnosis are more likely to have their physical health surveyed and responded to if they present for treatment in the mental health system. In this study, a physical health screening tool was administered to clients attending a community-based AOD service. The tool was administered by a counsellor during the initial phase of treatment, and referrals to health professionals were made as appropriate. Findings are discussed in terms of prevalence, types of problems identified and subsequent rates of referral. The results corroborate the known link between mental and physical ill health, and contribute to developing evidence that AOD clients present with equally concerning physical ill health to that of mental health clients and should equally be screened for such when presenting for AOD treatment.

The health service contact patterns of people with psychotic and non-psychotic forms of severe mental illness in New South Wales, Australia: A record-linkage study

2021 ◽  
pp. 000486742110314
Author(s):  
Rachael C Cvejic ◽  
Preeyaporn Srasuebkul ◽  
Adrian R Walker ◽  
Simone Reppermund ◽  
Julia M Lappin ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Illness ◽  
Health Service ◽  
Confidence Interval ◽  
Physical Health ◽  
Severe Mental Illness ◽  
New South ◽  
Service Utilisation ◽  
South Wales

Objective: To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms. Methods: We conducted a historical cohort study using linked administrative datasets, including data on public hospital admissions, emergency department presentations and ambulatory mental health service contacts in New South Wales, Australia. The study cohort comprised 169,306 individuals aged 12 years and over who were hospitalised at least once with a mental health diagnosis between 1 July 2002 and 31 December 2014. Of these, 63,110 had a recorded psychotic illness and 106,196 did not. Outcome measures were rates of hospital, emergency department and mental health ambulatory service utilisation, analysed using Poisson regression. Results: People with psychotic illnesses had higher rates of hospital admission (adjusted incidence rate ratio (IRR) 1.26; 95% confidence interval [1.23, 1.30]), emergency department presentation (adjusted IRR 1.17; 95% confidence interval [1.13, 1.20]) and ambulatory mental health treatment days (adjusted IRR 2.90; 95% confidence interval [2.82, 2.98]) than people without psychotic illnesses. The higher rate of hospitalisation among people with psychotic illnesses was driven by mental health admissions; while people with psychosis had over twice the rate of mental health admissions, people with other severe mental illnesses without psychosis (e.g. mood/affective, anxiety and personality disorders) had higher rates of physical health admissions, including for circulatory, musculoskeletal, genitourinary and respiratory disorders. Factors that predicted greater health service utilisation included psychosis, intellectual disability, greater medical comorbidity and previous hospitalisation. Conclusion: Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.

scholarly journals Physical health of people with severe mental illness

BMJ ◽  
2001 ◽  
Vol 322 (7284) ◽  
pp. 443-444 ◽  
Author(s):  
M. Phelan
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Severe Mental Illness
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