The Physical Health of Individuals Receiving Antipsychotic Medication: A Qualitative Inquiry on Experiences and Needs

Abstract

Individuals with a mental illness are reported to have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as cardiovascular disease and Type 2 diabetes. This inquiry sought to identify the physical health beliefs, experiences and needs of individuals with mental health problems in receipt of antipsychotic medication who live in the community. A qualitative inquiry was undertaken using three focus groups in a community mental health service in Ireland with 21 participants with mental health problems who were treated with antipsychotic medication. The participants were clear about the importance of good physical health as well as good mental health. They disliked the adverse effects of antipsychotic medication and experienced many barriers in accessing general practitioners/primary care services. They also preferred to receive health advice and self-management advice from the mental health services. The participants in this study were aware of the need to engage in health protective behaviours but were often overwhelmed by their comorbid health issues and the organizational and communication barriers in accessing their general practitioners.

Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis

“…However, even this type of free access was not always easy to get. Long waiting time was one of the concerns of the patients [ 17 , 21 ].…”

“…Key respondents believed that mental health patients’ levels of comprehension and attitudes concerning their cardiovascular risk varied [ 4 ], due to various factors such as their condition, lifestyle, or sociodemographics [ 25 ]. Some patients visited the GP only when they had some serious health conditions as they attribute most of their physical symptoms to mental illness [ 17 , 18 , 25 ]. However, GPs and mental health experts also believed that their patients’ physical health knowledge was generally inadequate as they generally focused more on their mental health than physical health [ 18 , 24 ].…”

“…Time/resource constraints . Short consultations with GP had a negative influence on communication which was acknowledged by the patient group [ 17 , 21 ]. When trying to educate and encourage patients to pay attention to their physical health, time restrictions in consultations were the most common challenge for GPs and psychiatrists [ 13 , 14 , 18 , 24 , 25 ].…”

“…Adverse effects of antipsychotics . The most common concerns expressed by the patients were weight and/or physical shape which made them feel embarrassed and harmed their confidence [ 17 , 26 ]. Other patients spoke about the long-term side effects of the medication and their effects on their bodies such as twitches, dry mouth, and sweating [ 17 ].…”

Switching antipsychotics to support the physical health of people with severe mental illness: a qualitative study of healthcare professionals’ perspectives

“…However, people with SMI have previously described a lack of acknowledgement from psychiatrists about the negative impacts of medication on their quality of life and physical health concerns. 23 Patients value the importance of good physical health, but often feel overwhelmed by comorbid health problems, 24 and may feel powerless in decision-making about APs and consider APs to be the 'least worst option' despite problematic side-effects. 23 HCPs in our study did not seem to engage patients in all aspects of AP decision-making, devaluing the insights that patients have.…”