Health Risks and Changes in Self-Efficacy Following Community Health Screening of Adults with Serious Mental Illnesses

Abstract

Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre- to post-screening increases in participants’ self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care.

Refocusing on physical health: Community psychiatric nurses’ perceptions of using enhanced health checks for people with severe mental illness

“…The CPN also mentioned that by seeing changes in their physical health conditions over time, their clients felt rewarded and were self-motivated to persist with health behaviour changes. This finding is supported by a recent study that provided health screening to 457 service users with SMI in the USA (Cook et al 2015); the results of that study found significant increases in the participants' perceived selfefficacy and ability to self-manage their physical health.…”

“…This finding is supported by a recent study that provided health screening to 457 service users with SMI in the USA (Cook et al . ); the results of that study found significant increases in the participants’ perceived self‐efficacy and ability to self‐manage their physical health.…”

Family carers: A role in addressing chronic disease risk behaviours for people with a mental illness?

“…Tobacco smoking, inadequate nutrition, harmful alcohol consumption and inadequate physical activity are the leading behavioural causes of the preventable chronic disease burden generally; (AIHW and O'Brien, 2005, Australian Bureau of Statistics, 2012, Australian Institute of Health and Welfare, 2012, Australian Institute of Health and Welfare, 2014) with the prevalence of such behaviours being consistently higher among people with a mental illness (Cook et al, 2015, Hahn et al, 2014, Kilbourne et al, 2009, Kilian et al, 2006, Morgan et al, 2014, Prochaska et al, 2014, Ussher et al, 2011, Bartlem et al, 2015). …”

Correlates of Current Smoking Among Adults Served by the Public Mental Health System

“…Studies using nonrepresentative outpatient populations receiving treatment for mental disorders typically find higher prevalence rates, ranging from 44.1% to 80% (Chesher et al, 2012;Cook et al, 2015;Dickerson et al, 2013;Vanable, Carey, Carey, & Maisto, 2003). One study of current psychiatric outpatients, limited to people with schizophrenia or bipolar disorder, reported a current smoking prevalence of 59% (Dickerson et al, 2013); another study found a current smoking prevalence of 46.4% for people reporting lifetime bipolar disorder and 59.1% for lifetime schizophrenia (McClave et al, 2010).…”