Study: Personalized care needed for mental illness and physical health conditions
People with severe mental illness can struggle to self-manage long-term physical conditions, and need personalized support, a new study suggests.
In a new study at the University of York, service users, caregivers and professionals described the impact of mental and physical symptoms on each other, with severe mental illness often being prioritized over physical health.
The study calls for services that bring together support for physical and mental health conditions, as well as personalized support that could include flexible appointments, longer consultations to discuss both physical and mental health conditions, and proactive follow-up to help them manage their medication and health.
Dr. Claire Carswell, from the University of York's Department of Health Sciences, said, "People with severe mental illness can often have symptoms that means they deprioritize other physical health issues, so we need a better understanding of how the two aspects of their health interact with each other.
"We know that people with severe mental illness have worse physical health than the general population, and their needs are complex, which means a 10-minute appointment with a GP or encouraging self-management is unlikely to benefit them."
People with severe mental illnesses, such as schizophrenia, have higher rates of physical illnesses that include lung conditions, diabetes and heart disease.
Programs aimed at helping the general population self-manage physical conditions do not address the difficulties experienced by people with severe mental illness.
The team used their findings to develop an app to help people with severe mental illness self-manage their type 2 diabetes. The intervention includes a workbook to include those who are reluctant to use technology. It will now be evaluated in a UK-wide trial.
Dr. Carswell said, "Many people are reluctant to engage with services because of previous distressing healthcare experiences, so a more proactive approach is needed for their care.
"It is clear we need a shift in thinking to allow people with severe mental illness more support, flexibility with appointments and follow-ups with the patient to see how they are managing their longer-term health. If we do not see these changes, then health inequalities will continue to increase for this vulnerable group of people."
More information: C. Carswell et al, The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions, BMC Psychiatry (2022). DOI: 10.1186/s12888-022-04117-5