Physical health care of people with severe mental illness
Christopher Dowrick in Global Primary Mental Health Care, 2019
The term “severe mental illness” is frequently used but is imprecise in its nature. In the generally accepted form, the term has three elements: Diagnosis, Disability and Duration. Diagnosis: A diagnosis of schizophrenia, bipolar disorder, or other psychotic disorder is usually implied.Disability: The disorder causes significant disability.Duration: The disorder has lasted for a significant duration, usually at least two years.Family doctors are in an ideal position to recognise, and/or treat or refer patients they see in general care. This chapter will present an evidence-based approach to management of patients with SMI emphasising the treatment of non-communicable diseases.
Group Interventions for Chronic Pain
Andrea Kohn Maikovich-Fong in Handbook of Psychosocial Interventions for Chronic Pain, 2019
Psychiatric Comorbidities: Many patients in any chronic pain treatment group inevitably will have comorbid mental health conditions (see Chapters 17–19). However, severe mental health symptoms either may need to be treated prior to group intervention or may be contraindications for group treatment entirely if they will interfere with the patient’s ability to benefit from group intervention and/or negatively impact the experiences of the other group members. Mental health conditions that may fall into this category include severe PTSD, panic disorder, and severe mental illness such as schizophrenia. Additionally, patients with underlying personality disorders, or with cluster A, B, and/or C symptoms, may be better suited to gain chronic pain management tools in an individual setting given the interpersonal disturbances fundamental to these conditions.
Central nervous system: Adult-onset and psychiatric disorders
Angus Clarke, Alex Murray, Julian Sampson in Harper's Practical Genetic Counselling, 2019
Two disorders, schizophrenia and affective disorder (which includes both manic-depressive illness or bipolar affective disorder and unipolar disorder with episodes of depression only), account for a considerable proportion of all serious mental illness. They are not only extremely disabling and distressing conditions, often occurring in young people, but also result in a major burden for the community in terms of long-term care. A considerable body of genetic research has been developed over several decades, utilising carefully planned twin and adoption studies as well as family data. Diagnostic criteria have been standardised to overcome inevitable difficulties of interpretation, while quantitative genetic analysis has been developed to circumvent the lack of any clear Mendelian inheritance pattern.
Supported accommodation for people with schizophrenia
Published in Nordic Journal of Psychiatry, 2019
Torhild Smith Wiker, Rolf Gjestad, Liv Solrunn Mellesdal, Erik Johnsen, Ketil Joachim Oedegaard, Rune Andreas Kroken
After four decades of deinstitutionalization in Norway, there is still an ongoing reduction in the number of psychiatric hospital beds, which has more than halved since 1990 (7745 beds in 1990, compared to 3769 beds in 2014). In the Western Norway Health Region, the number of psychiatric hospital beds has decreased by 23% over the last 10 years (2004–2014) [16,17]. Treatment, rehabilitation and care of people with severe mental illness must now, to a much larger extent, rely on service providers in, or close to, a person’s residence in the community, although hospital treatment may still be necessary for shorter periods for safety or treatment reasons. A report published by the Norwegian Ministry of Social and Health Affairs in 1997 concluded that services for people with mental illness at all levels were highly inadequate, and a national 10-year plan to escalate services was launched in 1998 [18]. This National Escalation Plan led to the establishment of increased community-based care, both as ambulatory psychiatric nursing services and a range of supported accommodation schemes. In a Norwegian setting, supported accommodation for people with severe mental illness includes apartments rented from the municipality, with supporting staff employed by the municipality. The level of staff qualification and staff-to-resident ratio are tailored according to the needs of the individual person. These forms of supported accommodation are additions to ‘Floating outreach and support’, where people, independent of living arrangement, can receive service from community psychiatric nursing staff.
Drop out from mental health treatment in the Saudi national mental health survey
Published in International Journal of Mental Health, 2022
Abdulaziz S. Alangari, Sarah S. Knox, Kim E. Innes, Alfgeir L. Kristjansson, Sijin Wen, Lisa Bilal, Abdulhameed Alhabeeb, Abdullah S. Al-Subaie, Yasmin A. Altwaijri
Our results suggest that participants who drop out of mental health treatment tend to do so early in the process. Drop out was significantly more likely to take place after one or two visits than after 3 or more visits, regardless of service type. Moreover, the number of providers was inversely associated with treatment dropout. These results are in agreement with findings of other WMH surveys (Fernández et al., 2020; Wang, 2007; Wells et al., 2013) and might, in part, reflect disorder severity and associated patient need for services. Based on this literature, it is possible that those with severe mental illness may be more likely to seek multiple types of care, and to be less likely to drop out because of need. Disorder severity was correlated with the probability of treatment in earlier analyses from 14 countries (Olfson et al., 2009), as well as in the most recent WMH survey study in 28 countries (Fernández et al., 2020). However, previous findings of SNMHS found no association between overall severity and service use (Al-Habeeb et al., 2020). We also found that those with any substance use (alcohol and drug abuse and dependence) were more likely to drop out than those without a diagnosed substance use disorder. This pattern has previously been reported only in Upper-middle-income countries (Wells et al., 2013).
Relationship between Physical Activity and Health Outcomes in Persons with Psychotic Disorders after Participation in a 2-Year Individualized Lifestyle Intervention
Published in Issues in Mental Health Nursing, 2023
Marjut Blomqvist, Andreas Ivarsson, Ing-Marie Carlsson, Anna Sandgren, Henrika Jormfeldt
However, the lack of confidence among health care providers in promoting physical activity and integrating physical activity into daily clinical practice has been highlighted as a barrier, implying a need for changes in working habits and organization of tasks in mental health services (Glowacki et al., 2019). Creating a need-supportive environment encouraging the possibility of physical activity has been demonstrated, which, in the context of mental health services, requires cooperation with other caregivers, such as social support and supported accommodation provided by municipalities (Farholm et al., 2017). Healthcare professionals working in mental health services have described that a common barrier to the promotion of physical activity is the belief that people with mental health difficulties do not overcome obstacles to engage in physical activity engagement (Glowacki et al., 2019). Thus, health promotion focus need to be integrated into all levels of mental health care, into the relationship with each patient, embedded in a joint vision within the working unit, and incorporated into decisions made at the management level (Lundström et al., 2020). A person with severe mental illness needs to be encountered as a unique and whole human being, as opposed to solely being viewed as a mental health patient, by all the involved care providers in cooperation if healthy living is to be truly enabled (Blomqvist et al., 2018; Rosenbaum et al., 2021).
Related Knowledge Centers
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