The chasm of care: Where does the mental health nursing responsibility lie for the physical health care of people with severe mental illness?

Abstract

The poor physical health of people with a severe mental illness is well documented and health professionals' attitudes, knowledge and skills are identified factors that impact on clients' access to care for their physical health needs. An evaluation was conducted to determine: (i) mental health nurses' attitudes and beliefs about providing physical health care; and, (ii) the effect that participant demographics may have on attitudes to providing physical health care. It was hypothesized that workplace culture would have the largest effect on attitudes. Nurses at three health services completed the "Mental health nurses' attitude towards the physical health care of people with severe and enduring mental illness survey" developed by Robson and Haddad (2012). The 28-item survey measured: nurses' attitudes, confidence, identified barriers to providing care and attitudes towards clients smoking cigarettes. The findings demonstrated that workplace culture did influence the level of physical health care provided to clients. However, at the individual level, nurses remain divided and uncertain where their responsibilities lie. Nursing leadership can have a significant impact on improving clients' physical health outcomes. Education is required to raise awareness of the need to reduce cigarette smoking in this client population.

Care coordinator views and experiences of physical health monitoring in clients with severe mental illness: A qualitative study

“…This corresponds with previous reports that role identities and diffusion of responsibility amongst mental health staff can detract from physical healthcare provision (Baxter et al, 2016;Happell et al, 2011;Wynaden et al, 2016).…”

“…This corresponds with previous reports that the burden of additional responsibilities related to physical health monitoring can act as a barrier to such tasks being successfully implemented by mental healthcare staff (Dunbar et al, 2010;Happell et al, 2011;Robson & Haddad, 2012;Wynaden et al, 2016). Thus, our findings indicate that to counter the view that physical health monitoring is a burdensome additional responsibility, it could be framed as a means to achieve improved working relationships with clients through providing comprehensive support.…”

“…To improve physical health monitoring practices, previous literature has recommended role clarification and appointing specific members of mental health service staff as responsible for physical health monitoring (Dunbar et al, 2010;Happell et al, 2011; Working Group for Improving the Physical Health of People with SMI, 2016), and training regarding the importance of attending to physical health for mental health staff (Baxter et al, 2016;Happell et al, 2013;Wynaden et al, 2016).…”

Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness

“…Thus, there might be other issues that impede the promotion of physical health. For example, there is a lack of consensus as to who should have responsibility for the physical health of people with SMI (Ehrlich et al ; Wynaden et al ), and mental health nurses appear to be ambivalent in their role of promoting physical health (Bradshaw & Pedley ; Happell et al ). Moreover, physical health is often under‐prioritized in mental health care (Gray & Brown ).…”

Survey of antipsychotic medication curriculum content in Australian university nursing programmes

“…Moreover, many of these side-effects can co-occur, and mental health consumers report that the resultant experience can be worse than the mental illness itself (Dibonaventura et al 2012;Morrison et al 2015bMorrison et al , 2016. Health professionals who prescribe or administer medications should also be responsible for monitoring the impact of medication, especially when its use could have detrimental consequences (Wynaden et al 2016).…”