Let's get physical: improving the medical care of people with severe mental illness

Abstract

<jats:title>Summary</jats:title><jats:p>There is clear evidence of increased medical comorbidity and related mortality in people with severe mental illness, despite numerous guidelines for managing medical conditions in this population. This article assesses inequalities in medical treatment and preventive healthcare received by psychiatric patients compared with the general population. It considers whether the medical care provided is adequate and whether published guidelines improve it. Mental health specialists, general practitioners and hospital specialists appear to deliver poorer than average medical care for this vulnerable population. Implementation of physical healthcare guidelines is incomplete and the guidelines must be matched with resources to address this deficit.</jats:p>

Medical–Surgical Nurses' Perceptions of Psychiatric Patients: A Review of the Literature With Clinical and Practice Applications

“…patients in the non-psychiatric clinical settings (Roos, 2005;Mitchell et al, 2012;Zolnierek, & Clingerman, 2012;MacNeela et al, 2012;Lethoba et al, 2006;and Zolnierek & Clingerman, 2012). This review identifies three primary areas needing further systematic attention as well as offering some practical and achievable methods for improving the care for SMI patients in non-psychiatric clinical settings: (1) education and training, (2) skills competency development, and (3) mentoring and supervision.…”

“…Additionally, and due in part to lack of insight, persons with SMI may refuse to accept their diagnosis, often refuse needed treatment, minimize pain, or insist on maintaining their independence despite this being contrary to their health and wellbeing (Roos, 2005;Mitchell et al, 2012;Zolnierek, & Clingerman, 2012). These health constraints may contribute to nurse's negative perceptions, add to treatment barriers, increase frequency of hospitalization and length of stay, and contribute to morbidity and even mortality results (Mitchell et al, 2012). Roos (2005) noted that nurses had a linear view of illness that is determined by the degree of physical limitation: those patients who fall outside of this physicalillness equation are at increased risk of being considered "not ill" and often labeled "difficult", which may lead to avoidance or segregation.…”

“…It is not uncommon for persons with SMI to present as if in good physical health and frequently deny having any problems (Roos, 2005;Mitchell et al, 2012). Additionally, and due in part to lack of insight, persons with SMI may refuse to accept their diagnosis, often refuse needed treatment, minimize pain, or insist on maintaining their independence despite this being contrary to their health and wellbeing (Roos, 2005;Mitchell et al, 2012;Zolnierek, & Clingerman, 2012). These health constraints may contribute to nurse's negative perceptions, add to treatment barriers, increase frequency of hospitalization and length of stay, and contribute to morbidity and even mortality results (Mitchell et al, 2012).…”

“…Faulty perceptions, negative attitudes, and a lack of blended knowledge and skills to effectively care for research scholars urge that psychiatric patients on non-psychiatric units receive the same standard of integrated care as those in the psychiatric unit(Druss et al, 2001;Mitchell et al, 2012). However, the literature is lacking the systematic evidence on how non-psychiatric nurses can achieve these specialized skills competency.…”

O paciente com transtorno mental grave no hospital geral: uma revisão bibliográfica

“…De acordo com os autores, o reconhecimento de que o estereótipo negativo direcionado a pacientes com comorbidades psiquiátricas pode influenciar suas atitudes é importante para auxiliar os profissionais na produção do cuidado (MCDONALD ET AL., 2003). Não apenas no hospital geral: dificuldades de acesso e baixa qualidade da atenção no sistema de saúde A literatura também aponta que os pacientes com comorbidades psiquiátricas recebem pior atendimento nos serviços de saúde de modo geral, trazendo implicações para a saúde dessa população (BRADSHAW ET AL., 2013;CAI;LI, 2013;RATHORE ET AL., 2008;MITCHELL;DELAFFON;LORD, 2012;LYKOURAS;DOUZENIS, 2008).…”