Physical health and mental illness: listening to the voice of carers.

PubMed

Happell, Brenda; Wilson, Karen; Platania-Phung, Chris; Stanton, Robert

2017-04-01

Shortened life expectancy of people with mental illness is now widely known and the focus of research and policy activity. To date, research has primarily reflected perspectives of health professionals with limited attention to the views and opinions of those most closely affected. The voice of carers is particularly minimal, despite policy stipulating carer participation is required for mental health services. To present views and opinions of carers regarding physical health of the people they care for. Qualitative exploratory. Two focus groups and one individual interview were conducted with 13 people identifying as carers of a person with mental illness. Research was conducted in the Australian Capital Territory. Data analysis was based on the thematic framework of Braun and Clarke. Two main themes were interaction between physical and mental health; and, carers' own physical and mental health. Participants described the impact of mental illness and its treatments on physical health, including their own. Carers are acknowledged as crucial for the delivery of high quality mental health services. Therefore they have an important role to play in addressing the poor physical health of people with mental illness. Hearing their views and opinions is essential.

Physical activity attitudes and preferences among inpatient adults with mental illness.

PubMed

Fraser, Sarah J; Chapman, Justin J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2015-10-01

The life expectancy of adults with mental illness is worse than that of the general population and is largely due to poor physical health status. Physical activity has been consistently recommended for the prevention and management of many chronic physical health conditions and can also have benefits for mental health. This cross sectional study assessed the attitudes towards and preferences for physical activity among inpatient adults with mental illness, and differences by distress and gender. Self-report questionnaires were completed by 101 patients. Findings indicated that inpatient adults with mental illness are interested in doing physical activity while in hospital, primarily to maintain good physical health and improve emotional wellbeing. Fewer than half of participants agreed that physical activity has benefits for serious mental illness. Participants indicated a preference for walking and physical activity that can be done alone, at a fixed time and with a set routine and format. Major barriers were fatigue and lack of motivation. Females were more likely than males to prefer activities done with others of the same gender (P = 0.001) and at the same level of ability (P < 0.001). There were no significant differences by level of distress. These findings can inform physical activity intervention programming in hospital settings, which may contribute to decreasing the chronic disease burden and improve the psychological wellbeing in adults with mental illness. © 2015 Australian College of Mental Health Nurses Inc.

Physical health care for people with mental illness: training needs for nurses.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-04-01

People diagnosed with serious mental illness have higher rates of physical morbidity and decreased longevity, yet these people are not adequately served by health care systems. Nurses may provide improved physical health support to consumers with serious mental illness but this is partly dependent on nurses having necessary skills and interest in training opportunities for this component of their work. This survey investigated Australian nurses' interest in training across areas of physical health care including lifestyle factors, cardiovascular disease, and identifying health risks. A nation-wide online survey of nurse members of the Australian College of Mental Health Nurses. The survey included an adapted version of a sub-section of the Physical Health Attitudes Scale. Participants were asked to indicate their interest in various aspects of physical health care training. Most (91.6%) participants viewed educating nurses in physical health care as of moderate or significant value in improving the physical health of people with serious mental illness. Interest in training in all areas of physical health care was over 60% across the health care settings investigated (e.g. public, private, primary care). Forty-two percent sought training in all nine areas of physical health care, from supporting people with diabetes, to assisting consumers with sexually-related and lifestyle issues. The findings suggest that nurses in mental health services in Australia acknowledge the importance of training to improve physical health care of consumers with serious mental illness. Training programs and learning opportunities for nurses are necessary to reduce inequalities in health of people with serious mental illness. Copyright © 2013. Published by Elsevier Ltd.

The association of illness perceptions with physical and mental health in systemic sclerosis patients: an exploratory study.

PubMed

Arat, Seher; Verschueren, Patrick; De Langhe, Ellen; Smith, Vanessa; Vanthuyne, Marie; Diya, Luwis; Van den Heede, Koen; Blockmans, Daniel; De Keyser, Filip; Houssiau, Frédéric A; Westhovens, René

2012-03-01

The aim of the present study was to evaluate the association between illness perceptions and the ability to cope with physical and mental health problems in a large cohort of systemic sclerosis (SSc) patients. This was a cross-sectional study in 217 systemic sclerosis patients from the Belgian Systemic Sclerosis Cohort. Illness perception and coping were measured by the Revised Illness Perception Questionnaire and a coping questionnaire--the Coping Orientation of Problem Experience inventory (COPE). Physical and mental health-related quality of life was measured by the 36-item short-form health survey (SF-36), as were disease activity and several severity parameters. The relationship between illness perceptions and the ability to cope with physical/mental health problems was examined using multiple linear regression analysis. According to LeRoy's classification, 49 patients had limited SSc (lSSc), 129 had limited cutaneous SSc (lcSSc) and 39 had diffuse cutaneous SSc (dcSSc). Median disease duration was five years and the modified Rodnan skin score was 4. Good physical health was significantly associated with the lcSSc subtype and low disease activity (p < 0.01 and p < 0.05, respectively). The perception of 'serious consequences' and strong 'illness identity' correlated with poor physical health (p < 0.001). Good mental health was associated with low illness identity scores and low 'emotional response' scores (p < 0.001). Coping variables were less significantly correlated with physical and mental health compared with the illness perception items. Illness representations contribute more than classical disease characteristics to physical and mental health. Copyright © 2011 John Wiley & Sons, Ltd.

Mental Health Nurses Attitudes and Practice Toward Physical Health Care in Jordan.

PubMed

Ganiah, Amal N; Al-Hussami, Mahmoud; Alhadidi, Majdi M B

2017-08-01

Patients with mental illnesses are at high risk for physical disorders and death. The aim of this study is to describe mental health nurses' attitudes and practice toward physical health care for patients with mental illnesses. A descriptive cross-sectional design was used to collect data using self- reported questionnaire from 202 mental health nurses working in mental health settings in Jordan. The study adopted translated version of Robson and Haddad Physical Health Attitudes Scale to the Arabic language. There was significant positive correlation between the participants' positive attitudes and their current practice (r = .388, p = .000), mental health nurses who have more positive attitudes regarding physical health care involved physical health care more in their current practice. Mental health nurses' attitudes affect the quality of care provided to patients with mental illnesses. The results provide implications for practice, education, and research.

Domain-Specific Physical Activity and Mental Health: A Meta-analysis.

PubMed

White, Rhiannon Lee; Babic, Mark J; Parker, Philip D; Lubans, David R; Astell-Burt, Thomas; Lonsdale, Chris

2017-05-01

The mental health benefits of physical activity are well established. However, less is known about whether the relationship between physical activity and mental health is consistent across different life domains. It is important to understand how context may influence the relationship between physical activity and mental health so that interventions and policy guidelines can be tailored to maximize positive effects. In 2015, systematic searches of four databases identified 13,435 records, of which 98 studies met the inclusion criteria. Included studies were published between 1988 and 2015 and had a combined sample size of 648,726. Of the 98 included studies, 93 examined leisure-time physical activity, 14 examined work-related physical activity, 15 examined transport physical activity, 16 examined household physical activity, three examined school sport, and three examined physical education. Multi-level meta-analyses showed that leisure-time physical activity (r =0.13) and transport physical activity (r =0.13) both had a positive association with mental health. Leisure-time physical activity (r = -0.11) and school sport (r = -0.09) both had an inverse association with mental ill-health. However, physical activity was not consistently associated with lower mental ill-health across domains, as work-related physical activity was positively associated with mental ill-health (r =0.09). Household physical activity and participation in physical education had no relationship with mental health or mental ill-health. The domain in which physical activity occurs influences the relationship between physical activity and mental health and should, therefore, be considered when developing interventions, treatment programs, and policy guidelines. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

What Physical Health Means to Me: Perspectives of People with Mental Illness.

PubMed

Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Bocking, Julia; Scholz, Brett; Stanton, Robert

2016-12-01

There are significant inequalities in physical health and life expectancy between people with and without a mental illness. Understanding perspectives of people with mental illness on personal meanings of physical health is essential to ensuring health services are aligned with consumer understandings, needs, and values. A qualitative exploratory study was undertaken involving focus groups with 31 consumers in The Australian Capital Territory, Australia. Participants were asked: "What does physical health mean to you?" Thematic analysis was applied to interview transcripts. Five themes are discussed, representing different emphases in the meaning of physical health: (1) physical and mental are interconnected, (2) absence of disease, (3) moving the body, (4) struggling for healthy diet, and (5) functioning and participation. Physical pain was a difficulty that arose across these themes. Mental health consumers see physical health as always connected with well-being. Nurses would benefit from been informed by consumer understandings of physical health. In addition, there should be more attention to quality of life measures of people with mental illness as these are more congruent with consumer perspectives on physical health than biomedical measures.

Integrating physical activity into mental health services for persons with serious mental illness.

PubMed

Richardson, Caroline R; Faulkner, Guy; McDevitt, Judith; Skrinar, Gary S; Hutchinson, Dori S; Piette, John D

2005-03-01

This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.

How patients and clinicians make meaning of physical suffering in mental health evaluations.

PubMed

Carson, Nicholas J; Katz, Arlene M; Alegría, Margarita

2016-10-01

Clinicians in community mental health settings frequently evaluate individuals suffering from physical health problems. How patients make meaning of such "comorbidity" can affect mental health in ways that may be influenced by cultural expectations and by the responses of clinicians, with implications for delivering culturally sensitive care. A sample of 30 adult mental health intakes exemplifying physical illness assessment was identified from a larger study of patient-provider communication. The recordings of patient-provider interactions were coded using an information checklist containing 21 physical illness items. Intakes were analyzed for themes of meaning making by patients and responses by clinicians. Post-diagnostic interviews with these patients and clinicians were analyzed in similar fashion. Clinicians facilitated disclosures of physical suffering to varying degrees and formulated them in the context of the culture of mental health services. Patients discussed their perceptions of what was at stake in their experience of physical illness: existential loss, embodiment, and limits on the capacity to work and on their sense of agency. The experiences of physical illness, mental health difficulties, and social stressors were described as mutually reinforcing. In mental health intakes, patients attributed meaning to the negative effects of physical health problems in relation to mental health functioning and social stressors. Decreased capacity to work was a particularly salient concern. The complexity of these patient-provider interactions may best be captured by a sociosomatic formulation that addresses the meaning of physical and mental illness in relation to social stressors. © The Author(s) 2016.

Association of physical activity with future mental health in older, mid-life and younger women.

PubMed

Griffiths, Amanda; Kouvonen, Anne; Pentti, Jaana; Oksanen, Tuula; Virtanen, Marianna; Salo, Paula; Väänänen, Ari; Kivimäki, Mika; Vahtera, Jussi

2014-10-01

Mental ill-health, particularly depression and anxiety, is a leading and increasing cause of disability worldwide, especially for women. We examined the prospective association between physical activity and symptoms of mental ill-health in younger, mid-life and older working women. Participants were 26 913 women from the ongoing cohort Finnish Public Sector Study with complete data at two phases, excluding those who screened positive for mental ill-health at baseline. Mental health was assessed using the 12-item General Health Questionnaire. Self-reported physical activity was expressed in metabolic equivalent task (MET) hours per week. Logistic regression models were used to analyse associations between physical activity levels and subsequent mental health. There was an inverse dose-response relationship between physical activity and future symptoms of mental ill-health. This association is consistent with a protective effect of physical activity and remained after adjustments for socio-demographic, work-related and lifestyle factors, health and body mass index. Furthermore, those mid-life and older women who reported increased physical activity by more than 2 MET hours per week demonstrated a reduced risk of later mental ill-health in comparison with those who did not increase physical activity. This protective effect of increased physical activity did not hold for younger women. This study adds to the evidence for the protective effect of physical activity for later mental health in women. It also suggests that increasing physical activity levels may be beneficial in terms of mental health among mid-life and older women. The alleviation of menopausal symptoms may partly explain age effects but further research is required. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

Folk concepts of mental disorders among Chinese-Australian patients and their caregivers.

PubMed

Hsiao, Fei-Hsiu; Klimidis, Steven; Minas, Harry I; Tan, Eng S

2006-07-01

This paper reports a study of (a) popular conceptions of mental illness throughout history, (b) how current social and cultural knowledge about mental illness influences Chinese-Australian patients' and caregivers' understanding of mental illness and the consequences of this for explaining and labelling patients' problems. According to traditional Chinese cultural knowledge about health and illness, Chinese people believe that psychotic illness is the only type of mental illness, and that non-psychotic illness is a physical illness. Regarding patients' problems as not being due to mental illness may result in delaying use of Western mental health services. Data collection took place in 2001. Twenty-eight Chinese-Australian patients with mental illness and their caregivers were interviewed at home, drawing on Kleinman's explanatory model and studies of cultural transmission. Interviews were tape-recorded and transcribed, and analysed for plots and themes. Chinese-Australians combined traditional knowledge with Western medical knowledge to develop their own labels for various kinds of mental disorders, including 'mental illness', 'physical illness', 'normal problems of living' and 'psychological problems'. As they learnt more about Western conceptions of psychology and psychiatry, their understanding of some disorders changed. What was previously ascribed to non-mental disorders was often re-labelled as 'mental illness' or 'psychological problems'. Educational programmes aimed at introducing Chinese immigrants to counselling and other psychiatric services could be made more effective if designers gave greater consideration to Chinese understanding of mental illness.

The utility of outpatient commitment: acute medical care access and protecting health.

PubMed

Segal, Steven P; Hayes, Stephania L; Rimes, Lachlan

2018-06-01

This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585  severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis. Mental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality.

The views and habits of the individuals with mental illness about physical activity and nutrition.

PubMed

Çelik Ince, Sevecen; Partlak Günüşen, Neslihan

2018-05-07

The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating. © 2018 Wiley Periodicals, Inc.

Investigating the exercise-prescription practices of nurses working in inpatient mental health settings.

PubMed

Stanton, Robert; Happell, Brenda; Reaburn, Peter

2015-04-01

Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population. © 2015 Australian College of Mental Health Nurses Inc.

Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

PubMed

Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S

2017-03-01

Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

Negative illness perceptions associated with low mental and physical health status in general hospital outpatients in China.

PubMed

Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer

2014-01-01

In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs.

Surveys of medical seeking preference, mental health literacy, and attitudes toward mental illness in Taiwan, 1990-2000.

PubMed

Wu, Chia-Yi; Liu, Shen-Ing; Chang, Shu-Sen; Sun, Fang-Ju

2014-01-01

Mental health promotion campaigns require a good understanding of public attitudes and mental health literacy. Few studies have investigated changes in these two aspects over time. We aimed to examine such changes and their associations with help-seeking preference in Taiwan. Data were extracted from the Taiwan Social Change Survey (1990, 1995, and 2000) based on national representative samples. Each wave of the surveys included four questions about attitudes toward severe mental illness, a case vignette describing depressive and anxiety symptoms to evaluate respondents' mental health literacy, and their preference of medical and/or informal help-seeking if they develop such symptoms. Mental and physical health statuses measured using the Chinese Health Questionnaire and self-reported chronic physical illnesses were included as covariates. There were 2531, 2075, and 1892 respondents in the three waves of the surveys, respectively. During the 1990 s, approximately one in four to five Taiwanese held some misconceptions toward mental illness. The attitudes toward mental illness were generally not associated with medical or informal help-seeking preference after statistical adjustment. However, respondents viewing symptoms in the vignette as physical or mental in origin were more willing to seek help than those who saw these symptoms as not being an illness. Attribution of depressive and anxiety symptoms appeared to be more likely to influence help-seeking behaviors than attitudes toward mental illness. Enhancing public mental health literacy toward depression may help facilitate help-seeking in response to potential mental illness. Copyright © 2013. Published by Elsevier B.V.

The relationship between quality of life and physical fitness in people with severe mental illness.

PubMed

Perez-Cruzado, D; Cuesta-Vargas, A I; Vera-Garcia, E; Mayoral-Cleries, F

2018-05-02

Quality of life of people with severe mental illness may be decrease by the high occurrence of metabolic and cardiovascular diseases. Physical fitness emerges as a modifying factor in this population through physical activity and this modification could influence in the quality of life of this population. The aim of the present study is to determine the contribution of physical fitness to the quality of life of people with severe mental illness. In the current study, a physiotherapist and an occupational therapist assessed 62 people with severe mental illness. Physical fitness was measured with a range of 11 fitness tests that covered flexibility, strength, balance, and endurance. To assess quality of life the EQ-5D-3 L scale was used, which measures five dimensions (mobility, self-care, usual activities, pain-discomfort, and anxiety-depression). Significant correlations are presented between the quality of life and primary variables of physical fitness (balance, endurance, and upper limb strength). Endurance explained 22.9% of the variance of the quality of life in people with severe mental illness. Functional reach added another 36.2% variance to the prediction of quality of life. The results of the present study suggest that some variables of physical fitness are associated with quality of life in people with severe mental illness. The improvement in physical fitness of this population should be a primary objective. ClinicalTrials.gov Identifier: NCT02413164 "retrospective registered" Registered Febr 2017.

Somali Refugees' Perceptions of Mental Illness.

PubMed

Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

2015-01-01

Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

Checking physical care of people on risperidone long term injectable depot.

PubMed

Najim, Hellme; Islam, Nazrul

2013-09-01

To assess the existing physical care of patients with severe mental illness and whether it has complied with national protocols and guidelines. Medical notes of patients who has been on risperidone long acting injectable depot for a year were reviewed and a form was filled with the information of each patient including weight, physical examination, fasting blood sugar (FBS), Serum lipid (S.L.), pulse, blood pressure and ECG liver function tests (LFT). 50% had comorbidity with other physical illness, at the start of treatment, at three months and six months intervals. 65 notes were reviewed. 70% males. 70% between 18-50 years. 80% had the illness more than 5 years and 50% more than 10 years. The following was done baseline: 50% had physical examination. 25% had pulse, blood pressure and ECG. Body weight 10%. Triglycerides 20%. Urea and electrolytes (U&E) 15%. 40% had their liver function tests (LFT). 50% had comorbidity with other physical illness. The following were done on six monthly maintenance measures: Only 5% had maintenance ECG. LFT 10%. U&E 30%. Triglycerides 5%. Physical illnesses are neglected areas in the care of the severely mentally ill patients. It is an important area in the management of severe mental illness. Proper physical assessment and regular follow up should be adopted. Promotion of healthy living and eating, exercise and monitoring weight should be recommended. All these measures may improve the physical health of severely mentally ill patients and improve the total outcome of these illnesses.

Perceptions of discrimination among persons with serious mental illness.

PubMed

Corrigan, Patrick; Thompson, Vetta; Lambert, David; Sangster, Yvette; Noel, Jeffrey G; Campbell, Jean

2003-08-01

The authors sought to gain further perspective on discrimination experienced by persons with mental illness by comparing self-reports of discrimination due to mental illness to self-reports of discrimination due to other group characteristics, such as race, gender, and sexual orientation. A total of 1,824 persons with serious mental illness who participated in a baseline interview for a multistate study on consumer-operated services completed a two-part discrimination questionnaire. The first part of the questionnaire assessed participants' perceptions about discrimination due to mental illness as well as more than half a dozen other group characteristics. The second part of the questionnaire asked participants who reported some experience with discrimination to identify areas in which this discrimination occurred, such as employment, education, and housing. More than half of the study participants (949 participants, or 53 percent) reported some experience with discrimination. The most frequent sources of this discrimination were mental disability, race, sexual orientation, and physical disability. Areas in which discrimination frequently occurred included employment, housing, and interactions with law enforcement. Areas in which discrimination was experienced did not significantly differ among groups of study participants characterized by mental disability, race, gender, sexual orientation, or physical disability. Discrimination based on group characteristics other than mental illness does not diminish the impact of stigma associated with mental illness. Antistigma programs need to target not only discrimination related to mental illness but also that associated with other group characteristics, such as race, gender, sexual orientation, and physical disability.

'That red flag on your file': misinterpreting physical symptoms as mental illness.

PubMed

Happell, Brenda; Ewart, Stephanie B; Bocking, Julia; Platania-Phung, Chris; Stanton, Robert

2016-10-01

To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs. People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers. Exploratory qualitative. Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed. The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation. Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously. Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care. © 2016 John Wiley & Sons Ltd.

Perceived barriers to physical activity in older and younger veterans with serious mental illness.

PubMed

Muralidharan, Anjana; Klingaman, Elizabeth A; Molinari, Victor; Goldberg, Richard W

2018-03-01

Individuals with serious mental illness endorse many more medical and psychosocial barriers to physical activity (PA) than the general population. However, it is unknown if older adults with serious mental illness are at greater risk of experiencing barriers to PA than their younger counterparts. The present study utilized a national VA dataset to compare veterans with serious mental illness ages 55 and older (n = 9,044) to veterans with serious mental illness ages 54 and younger (n = 8,782) on their responses to a questionnaire assessment of barriers to PA. Older veterans were more likely to endorse arthritis and cardiopulmonary disease, and less likely to endorse work schedule, as barriers to PA. Interventions designed to increase PA for young/middle-aged adults with serious mental illness may be broadly useful for older adults with serious mental illness, with some modification to address specific health concerns. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Proposed nurse-led initiatives in improving physical health of people with serious mental illness: a survey of nurses in mental health.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2014-04-01

To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). A national, cross-sectional and nonrandom survey study delivered online. Members of the Australian College of Mental Health Nurses (n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive health care of people with serious mental illness. © 2013 John Wiley & Sons Ltd.

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

PubMed

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor physical health to improve physical health outcomes in people with serious mental illness. © 2016 John Wiley & Sons Ltd.

The future of mental health care: peer-to-peer support and social media.

PubMed

Naslund, J A; Aschbrenner, K A; Marsch, L A; Bartels, S J

2016-04-01

People with serious mental illness are increasingly turning to popular social media, including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from others with similar health conditions. This emerging form of unsolicited communication among self-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections among people with serious mental illness could advance efforts to promote mental and physical wellbeing in this group. In this commentary, we take the perspective that when an individual with serious mental illness decides to connect with similar others online it represents a critical point in their illness experience. We propose a conceptual model to illustrate how online peer-to-peer connections may afford opportunities for individuals with serious mental illness to challenge stigma, increase consumer activation and access online interventions for mental and physical wellbeing. People with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours. These individuals could also access interventions for mental and physical wellbeing delivered through social media that could incorporate mutual support between peers, help promote treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading information, facing hostile or derogatory comments from others, or feeling more uncertain about one's health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks. Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world.

The future of mental health care: peer-to-peer support and social media

PubMed Central

Naslund, J. A.; Aschbrenner, K. A.; Marsch, L. A.; Bartels, S. J.

2016-01-01

Aims People with serious mental illness are increasingly turning to popular social media, including Facebook, Twitter or YouTube, to share their illness experiences or seek advice from others with similar health conditions. This emerging form of unsolicited communication among self-forming online communities of patients and individuals with diverse health concerns is referred to as peer-to-peer support. We offer a perspective on how online peer-to-peer connections among people with serious mental illness could advance efforts to promote mental and physical wellbeing in this group. Methods In this commentary, we take the perspective that when an individual with serious mental illness decides to connect with similar others online it represents a critical point in their illness experience. We propose a conceptual model to illustrate how online peer-to-peer connections may afford opportunities for individuals with serious mental illness to challenge stigma, increase consumer activation and access online interventions for mental and physical well-being. Results People with serious mental illness report benefits from interacting with peers online from greater social connectedness, feelings of group belonging and by sharing personal stories and strategies for coping with day-to-day challenges of living with a mental illness. Within online communities, individuals with serious mental illness could challenge stigma through personal empowerment and providing hope. By learning from peers online, these individuals may gain insight about important health care decisions, which could promote mental health care seeking behaviours. These individuals could also access interventions for mental and physical wellbeing delivered through social media that could incorporate mutual support between peers, help promote treatment engagement and reach a wider demographic. Unforeseen risks may include exposure to misleading information, facing hostile or derogatory comments from others, or feeling more uncertain about one’s health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks. Conclusion Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world. PMID:26744309

World survey of mental illness stigma.

PubMed

Seeman, Neil; Tang, Sabrina; Brown, Adalsteinn D; Ing, Alton

2016-01-15

To obtain rapid and reproducible opinions that address mental illness stigma around the world. Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome. Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1 ± 0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response. This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured. The method engages English speakers only, mainly young, educated males. Copyright © 2015 Elsevier B.V. All rights reserved.

The impact of lifestyle factors on the physical health of people with a mental illness: a brief review.

PubMed

Stanley, Susanne; Laugharne, Jonathan

2014-04-01

People with a mental illness are much more likely to experience poor physical health when compared to the general population, showing a higher propensity to develop the metabolic syndrome. Past focus has predominantly been upon individuals treated with antipsychotics, yet poor physical health is occurring across diagnoses. The purpose of this paper is to draw attention to the major factors within the domain of lifestyle in order to support the need for more detailed and rigorous physical health assessment and ongoing monitoring for people with a mental illness. This paper reviews existing evidence relating to lifestyle factors such as low exercise levels, poor diet and nutrition, high cholesterol levels, tobacco smoking and poor dental care, contributing to poor physical health such as a higher incidence of cardiovascular disease and type 2 diabetes. An integrative review was conducted from a multi-disciplinary search of online databases and journals, focusing upon mental illness and lifestyle issues predominant in the literature. The findings reviewed here suggest that greater attention should be paid to the physical health assessment and ongoing monitoring of all people with mental health disorders so that preventable illness does not result in higher levels of morbidity and mortality for this disadvantaged population. Early identification aids preventive interventions and assists clinicians and mental health staff to more effectively treat emergent physical health problems.

The stigma of mental illness in the labor market.

PubMed

Hipes, Crosby; Lucas, Jeffrey; Phelan, Jo C; White, Richard C

2016-03-01

Mental illness labels are accompanied by devaluation and discrimination. We extend research on reactions to mental illness by utilizing a field experiment (N = 635) to test effects of mental illness labels on labor market discrimination. This study involved sending fictitious applications to job listings, some applications indicating a history of mental illness and some indicating a history of physical injury. In line with research indicating that mental illness leads to stigma, we predicted fewer callbacks to candidates with mental illness. We also predicted relatively fewer callbacks for applicants with mental illness when the jobs involved a greater likelihood for interpersonal contact with the employer. Results showed significant discrimination against applicants with mental illness, but did not indicate an effect of potential proximity to the employer. This contributes a valuable finding in a natural setting to research on labor market discrimination towards people with mental illness. Copyright © 2015 Elsevier Inc. All rights reserved.

Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

ERIC Educational Resources Information Center

Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

2012-01-01

The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

How does mental-physical multimorbidity express itself in lived time and space? A phenomenological analysis of encounters with depression and chronic physical illness.

PubMed

Coventry, Peter A; Dickens, Chris; Todd, Chris

2014-10-01

Mental-physical multimorbidity (the co-existence of mental and physical ill health) is highly prevalent and associated with significant impairments and high healthcare costs. While the sociology of chronic illness has developed a mature discourse on coping with long term physical illness the impact of mental and physical health have remained analytically separated, highlighting the need for a better understanding of the day-to-day complexities encountered by people living with mental-physical multimorbidity. We used the phenomenological paradigm of the lived body to elucidate how the experience of mental-physical multimorbidity shapes people's lifeworlds. Nineteen people with chronic obstructive pulmonary disease (COPD) and depression (defined as a score ≥8 on depression scale of Hospital Anxiety and Depression Scale) were recruited from secondary NHS care and interviewed at their homes. Data were analysed phenomenologically using van Manen's lifeworld existential framework of the lived body, lived time, lived space, lived relations. Additionally, we re-analysed data (using the same framework) collected from 13 people recruited from secondary NHS care with either COPD, rheumatoid arthritis, heart disease, or type 1 or type 2 diabetes and depression. The phenomenology of mental-physical multimorbidity was articulated through embodied and emotional encounters with day-to-day life in four ways: [a] participants' perception of lived time and lived space contracted; [b] time and [c] space were experienced as liminal categories, enforcing negative mood and temporal and spatial contraction; and [d] time and space could also be customised to reinstate agency and self-determination. Mental-physical multimorbidity negatively impacts on individuals' perceptions of lived time and lived space, leading to a loss of agency, heightened uncertainty, and poor well-being. Harnessing people's capacity to modify their experience of time and space may be a novel way to support people with mental-physical multimorbidity to live well with illness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis.

PubMed

Yang, Lawrence H; Wonpat-Borja, Ahtoy J

2012-08-01

Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of 'mental illness' as opposed to other 'indigenous labels' may promote more effective mental health service use. We examine what effects beliefs of 'physical causes' and other non-biomedical causal beliefs ('general social causes', and 'indigenous Chinese beliefs' or culture-specific epistemologies of illness) might have on mental illness identification. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Higher endorsement of 'physical causes' was associated with mental illness labeling. However among the non-biomedical causal beliefs, 'general social causes' demonstrated no relationship with mental illness identification, while endorsement of 'indigenous Chinese beliefs' showed a negative relationship. Effective treatment- and community-based psychoeducation, in addition to emphasizing biomedical models, might integrate indigenous Chinese epistemologies of illness to facilitate rapid identification of psychotic disorders and promote treatment use.

Validating a Lifestyle Physical Activity Measure for People with Serious Mental Illness

ERIC Educational Resources Information Center

Bezyak, Jill L.; Chan, Fong; Chiu, Chung-Yi; Kaya, Cahit; Huck, Garrett

2014-01-01

Purpose: To evaluate the measurement structure of the "Physical Activity Scale for Individuals With Physical Disabilities" (PASIPD) as an assessment tool of lifestyle physical activities for people with severe mental illness. Method: A quantitative descriptive research design using factor analysis was employed. A sample of 72 individuals…

Chronic physical illness, psychiatric disorder and disability in the workplace.

PubMed

Dewa, C S; Lin, E

2000-07-01

While agreement is growing that mental illness burdens the North American economy, how it impacts productivity--particularly compared to physical illness--is unclear. Hypothesizing that lost work days are only the tip of the iceberg, we also examined the association of mental and chronic physical illness with partial work days and days requiring extra effort to function. Data from 4225 employed individuals, aged 18-54, were analyzed. These were a subset of respondents to the Ontario Health Survey's Mental Health Supplement, a 1990/91 epidemiologic survey of households across Ontario, Canada. Psychiatric disorder was assessed using the University of Michigan' modification of WHO's Composite International Diagnostic Interview (UM-CIDI). Similar to US reports, professional/managerial groups had lower rates of affective and anxiety disorders and fewer disability days compared to the rest of the workforce. However, no single occupational group was consistently at greater risk for either physical or psychiatric problems. Even after accounting for sociodemographic characteristics and work conditions, mental and physical status had clear, but different, impacts on productivity. Physical conditions alone had a fairly constant effect across all types of disability days and were the largest contributor to total work day loss. They also significantly impacted partial and extra effort days but were far less important than conditions involving a mental disorder. Respondents with mental health problems, either alone or in combination with physical illnesses, appeared more likely to go to work but to require greater effort to function. WHO projects that mental illness will become the second most important cause of global disease burden in the next century. Our findings suggest that among working individuals, it affects productivity more subtly than does physical illness. However, with an estimated eight percent of Ontario's workforce experiencing more than two months annually of decreased productivity, it still incurs significant social and economic costs.

Childhood developmental vulnerabilities associated with early life exposure to infectious and noninfectious diseases and maternal mental illness.

PubMed

Green, Melissa J; Kariuki, Maina; Dean, Kimberlie; Laurens, Kristin R; Tzoumakis, Stacy; Harris, Felicity; Carr, Vaughan J

2017-12-26

Fetal exposure to infectious and noninfectious diseases may influence early childhood developmental functioning, on the path to later mental illness. Here, we investigated the effects of in utero exposure to maternal infection and noninfectious diseases during pregnancy on offspring developmental vulnerabilities at age 5 years, in the context of estimated effects for early childhood exposures to infectious and noninfectious diseases and maternal mental illness. We used population data for 66,045 children from an intergenerational record linkage study (the New South Wales Child Development Study), for whom a cross-sectional assessment of five developmental competencies (physical, social, emotional, cognitive, and communication) was obtained at school entry, using the Australian Early Development Census (AEDC). Child and maternal exposures to infectious or noninfectious diseases were determined from the NSW Ministry of Health Admitted Patients Data Collection (APDC) and maternal mental illness exposure was derived from both APDC and Mental Health Ambulatory Data collections. Multinomial logistic regression analyses were used to examine unadjusted and adjusted associations between these physical and mental health exposures and child developmental vulnerabilities at age 5 years. Among the physical disease exposures, maternal infectious diseases during pregnancy and early childhood infection conferred the largest associations with developmental vulnerabilities at age 5 years; maternal noninfectious illness during pregnancy also retained small but significant associations with developmental vulnerabilities even when adjusted for other physical and mental illness exposures and covariates known to be associated with early childhood development (e.g., child's sex, socioeconomic disadvantage, young maternal age, prenatal smoking). Among all exposures examined, maternal mental illness first diagnosed prior to childbirth conferred the greatest odds of developmental vulnerability at age 5 years. Prenatal exposure to infectious or noninfectious diseases appear to influence early childhood physical, social, emotional and cognitive developmental vulnerabilities that may represent intermediate phenotypes for subsequent mental disorders. © 2017 Association for Child and Adolescent Mental Health.

Medication and physical activity and physical fitness in severe mental illness.

PubMed

Perez-Cruzado, David; Cuesta-Vargas, Antonio; Vera-Garcia, Elisa; Mayoral-Cleries, Fermín

2018-05-23

Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers. Copyright © 2018 Elsevier B.V. All rights reserved.

Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness.

PubMed

Fraser, Sarah J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2018-04-01

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non-communicable disease. This repeated-measures, single-group intervention trial evaluated the effects of a 19-week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face-to-face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self-report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically-significant changes were demonstrated between baseline and post intervention for participants' waist circumference (P = 0.035) and waist-to-height ratio (P = 0.037). Non-significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse-led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an 'open door' policy to allow for attendance interruptions, such as hospitalization. © 2017 Australian College of Mental Health Nurses Inc.

Effects of social networks on physical health among people with serious mental illness.

PubMed

Lee, Sungkyu; Wong, Yin-Ling Irene; Rothbard, Aileen

2014-12-01

This study examined the effects of social network characteristics on physical health among people with serious mental illness using social transactions that are reciprocal, and the combination of objective and subjective health measures. The sample consisted of a probability sample of 231 adults with serious mental illness who resided in permanent supportive housing in Philadelphia, Pennsylvania. Path analyses were conducted to examine the relationships between social network characteristics and two aspects of medical comorbidity, objective health and subjective health. Bivariate statistics showed that individuals with medical comorbidity were more likely to have contact with their network members and had a higher level of reciprocal positive tangible support when compared to those who did not have medical comorbidity. The results of the path analyses revealed that none of the social network characteristics were associated with better physical health. The lack of a significant relationship between social networks and better physical health is contrary to prior research findings. However, this is the first study to include both types of social transactions simultaneously as predictors of better physical health for individuals with serious mental illness. A longitudinal study would provide more insight into the temporal relationship of social networks and physical health conditions of people with serious mental illness. Furthermore, the transactional nature of social relationships, particularly for those with mental health issues, requires greater exploration.

Making sense of self-care practices at the intersection of severe mental illness and physical health-An Australian study.

PubMed

Ehrlich, Carolyn; Chester, Polly; Kisely, Steve; Crompton, David; Kendall, Elizabeth

2018-01-01

The poor physical health of people who experience severe mental illness (SMI) is an important public health issue that has been acknowledged, yet not properly addressed. People who live with SMI perform a myriad of complex tasks in order to take care of their physical health, while receiving unpredictable levels of support and assistance from health professionals. In this qualitative study, we aimed to uncover the kinds of work people with SMI do in order to look after their physical health. In a metropolitan area in Queensland, Australia, 32 people with lived experience of SMI participated in semi-structured, face-to-face interviews. Data were digitally recorded, transcribed verbatim and open coded. They were then themed using a constant comparative process. We found that people with SMI were engaged in a "rhythm of life with illness" that consisted of relatively short, acute and chaotic cycles of mental and physical illness, accompanied by much longer mental and physical illness recovery cycles. Participants engaged in three specific types of health-related work to manage these cycles: discovery work (and the associated role of the health professional); sense-making work to meaningfully interpret health and illness; and embedding work to become engaged self-managers of illness and producers of health. We discuss how varying levels of support from health professionals impact consumers' self-management of their physical and mental health; how health professionals influence consumers' experience of treatment burden; and implications for practice. © 2017 John Wiley & Sons Ltd.

Social anxiety in physical activity participation in patients with mental illness: a cross-sectional multicenter study.

PubMed

De Herdt, Amber; Knapen, Jan; Vancampfort, Davy; De Hert, Marc; Brunner, Emanuel; Probst, Michel

2013-08-01

Social anxiety (SA) is a frequent comorbid condition in patients with mental illness. However, no data exist regarding SA in physical activity (PA) situations. The aim of the present study was to measure the level of self-reported SA in PA participation in patients with mental illness compared to healthy controls. Six hundred ninety-three patients with mental illness and 2,888 controls aged between 18 and 65 years completed the Physical Activity and Sport Anxiety Scale (PASAS). Group and gender differences in PASAS scores were tested by ANOVA and Scheffé's post hoc test. After controlling for gender (P < .05), the patient group (men 40.2 ± 14.4; women 49.2 ± 17) scored higher on the PASAS compared to control group (men 30.6 ± 12.2; women 37.3 ± 13.7). Within both groups, women reported higher levels of SA compared to men. Our data indicate that patients with mental illness reported higher levels of SA in PA situations compared to healthy control subjects. Health professionals should consider SA when trying to improve outcome and adherence of patients with mental illness to PA interventions. © 2013 Wiley Periodicals, Inc.

Effects of comorbid health conditions on healthcare expenditures among people with severe mental illness.

PubMed

Lee, Sungkyu; Rothbard, Aileen; Choi, Sunha

2016-08-01

Little is known about the incremental cost burden associated with treating comorbid health conditions among people with severe mental illness (SMI). This study compares the extent to which each individual medical condition increases healthcare expenditures between people with SMI and people without mental illness. Data were obtained from the 2011 Medical Expenditure Panel Survey (MEPS; N = 17 764). Mental illness and physical health conditions were identified through ICD-9 codes. Guided by the Andersen's behavioral model of health services utilization, generalized linear models were conducted. Total healthcare expenditures among individuals with SMI were approximately 3.3 times greater than expenditures by individuals without mental illness ($11 399 vs. $3449, respectively). Each additional physical health condition increased the total healthcare expenditure by 17.4% for individuals with SMI compared to the 44.8% increase for individuals without mental illness. The cost effect of having additional health conditions on the total healthcare expenditures among individuals with SMI is smaller than those individuals without mental illness. Whether this is due to limited access to healthcare for the medical problems or better coordination between medical and mental health providers, which reduces duplicated medical procedures or visits, requires future investigation.

Obesity, cardiovascular disease and type 2 diabetes in people with a mental illness: a need for primary health care.

PubMed

Stanley, Susanne H; Laugharne, Jonathan D E

2012-01-01

People with a mental illness show a growing incidence of obesity, and higher rates of metabolic syndrome when compared with the general population. This paper reviews research on obesity, cardiovascular disease and type 2 diabetes, with the aim of directing clinical attention towards the improvement of patient physical health. A systematic search of cross-discipline databases and journals provided peer-reviewed research for analysis, and national statistics allowed for the investigation of differences in rates of occurrence between people experiencing a mental illness and the general population. Treatment effects via psychotropic medications and lifestyle factors such as poor diet and low levels of exercise suggest that ongoing monitoring is necessary to prevent major physical disorders in people experiencing a mental illness. To aid clinicians, a comprehensive set of clinical guidelines have been developed for the physical assessment and ongoing monitoring of mental health patients.

Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis

PubMed Central

Wonpat-Borja, Ahtoy J.

2013-01-01

Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of ‘mental illness’ as opposed to other ‘indigenous labels’ may promote more effective mental health service use. We examine what effects beliefs of ‘physical causes’ and other non-biomedical causal beliefs (‘general social causes’, and ‘indigenous Chinese beliefs’ or culture-specific epistemologies of illness) might have on mental illness identification. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Higher endorsement of ‘physical causes’ was associated with mental illness labeling. However among the non-biomedical causal beliefs, ‘general social causes’ demonstrated no relationship with mental illness identification, while endorsement of ‘indigenous Chinese beliefs’ showed a negative relationship. Effective treatment- and community-based psychoeducation, in addition to emphasizing biomedical models, might integrate indigenous Chinese epistemologies of illness to facilitate rapid identification of psychotic disorders and promote treatment use. PMID:22075770

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

PubMed

Gronholm, Petra C; Onagbesan, Oluwadamilola; Gardner-Sood, Poonam

2017-11-01

Excess mortality among people with severe mental illness (SMI) is largely attributed to co-morbid physical illness. Improving the physical health of this population is critically important; however, physical health monitoring among people with SMI is often inadequate. This study aimed to facilitate an enhanced understanding of barriers to successfully attend to clients' physical health in mental health settings, through exploring care coordinators' views and experiences regarding their ability to monitor physical health in clients with SMI (specifically, psychosis). Semi-structured interviews were conducted with seven care coordinators from a South East London (UK) community mental health team. Data were analysed using thematic analysis principles. Three themes were identified in these data, capturing (1) how care coordinators viewed the professional roles of other clinical staff and themselves, (2) views on barriers to the provision of physical healthcare and (3) factors that motivated care coordinators to attend to clients' physical health. Our findings can inform efforts to implement physical healthcare interventions within mental health settings. Such insights are timely, as academic literature and guidelines regarding clinical practice increasingly promote the value of integrated provision of mental and physical healthcare.

Diagnostic overshadowing and other challenges involved in the diagnostic process of patients with mental illness who present in emergency departments with physical symptoms--a qualitative study.

PubMed

Shefer, Guy; Henderson, Claire; Howard, Louise M; Murray, Joanna; Thornicroft, Graham

2014-01-01

We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of 'diagnostic overshadowing'--the misattribution of physical symptoms to mental illness--and other challenges involved in the diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.

Participative mental health consumer research for improving physical health care: An integrative review.

PubMed

Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Stanton, Robert

2016-10-01

People with mental illness have a significantly lower life expectancy and higher rates of chronic physical illnesses than the general population. Health care system reform to improve access and quality is greatly needed to address this inequity. The inclusion of consumers of mental health services as co-investigators in research is likely to enhance service reform. In light of this, the current paper reviews mental health consumer focussed research conducted to date, addressing the neglect of physical health in mental health care and initiatives with the aim of improving physical health care. The international literature on physical healthcare in the context of mental health services was searched for articles, including mental health consumers in research roles, via Medline, CINAHL and Google Scholar, in October 2015. Four studies where mental health consumers participated as researchers were identified. Three studies involved qualitative research on barriers and facilitators to physical health care access, and a fourth study on developing technologies for more effective communication between GPs and patients. This review found that participatory mental health consumer research in physical health care reform has only become visible in the academic literature in 2015. Heightened consideration of mental health consumer participation in research is required by health care providers and researchers. Mental health nurses can provide leadership in increasing mental health consumer research on integrated care directed towards reducing the health gap between people with and without mental illness. © 2016 Australian College of Mental Health Nurses Inc.

Behavioral health benefits for public employees: effect of mental health parity legislation.

PubMed

Borzi, P C; Rosenbaum, S

2001-04-01

With the passage of the Mental Health Parity Act of 1996 (MHPA), Congress took an important first step toward equalizing treatment under medical plans between physical and mental illnesses by requiring parity in annual and lifetime dollar limits between physical and mental illness. But the Act was limited in scope: it did not mandate mental health benefits nor prohibit other common types of differentials between physical and mental illnesses, such as higher cost-sharing or lower limits on outpatient visits or inpatient treatments. Before Congress' action in 1996, a few of the states had adopted some type of parity requirement. Since 1996, state parity activity has accelerated.Recently, the Center for Health Services Research and Policy through a grant from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services, examined contracts providing for mental health benefits for state employees in eight states to assess whether legislative attempts to require parity between physical and mental illnesses resulted in noticeable differences in behavioral health benefits for state employees. We concluded that, except in states that have mandated full parity for some or all types of mental illnesses, behavioral health benefits for state employees have not changed significantly as a result of the state parity laws, since they still remain subject to traditional restrictions, such as higher cost-sharing and greater limitations on outpatient visits and inpatient treatment days, than those imposed on physical illnesses. Thus the considerable state activity surrounding mental health parity may have little effect on state employees' access to mental health services, since although state laws required parity in dollar limitations, they generally permitted the continuation of other plan design features that are more restrictive for mental health coverage. However, many of the contracts we examined were multi-year contract and may not have fully reflected recent state activity. Moreover, if Congress renews the Mental Health Parity Act when it expires in September, 2001, and expands the scope of the Act to cover some of these other plan design features, states with more limited parity laws are likely to follow. In that case, perhaps state employees with mental illnesses may see significant change in the future.

An Anthropological View of the Change in Attitudes toward Mental Illnesses and Physical Handicaps.

ERIC Educational Resources Information Center

Ross, John Alan

1983-01-01

Anthropologists contend that throughout man's history mental illness has been part of all cultures, and, universally, peoples had taxonomies that classified such maladies. Primitive peoples were better able to treat culturally-defined mental illnesses and could, consequently, accommodate behaviors which in Western cultures would require…

Exploring the role of physical activity for people diagnosed with serious mental illness in Ireland.

PubMed

Cullen, C; McCann, E

2015-02-01

The aim of the study was to elicit the views and opinions of people diagnosed with serious mental illness in relation to physical activity. Ten people who were attending a community mental health centre participated in semi-structured interviews. The main results showed that participants found physical activity beneficial in terms of psychological and social well-being and perceived clear gains in relation to recovery and quality of life. Physical activity should be routinely included in plans of care and mental health policy guidelines globally should contain physical activity as a key component. Mental health policy guidelines globally should contain physical activity as a key component. The aim of the current study was to explore the subjective experiences of people diagnosed with serious mental illness (SMI) in relation to physical activity. The study was conducted using a qualitative exploratory descriptive approach. The participants (n = 10), who were outpatients attending a day centre, were interviewed to elicit their views and opinions about physical activity. The data were thematically analysed using a recognized framework. The main themes that emerged included physical activity as a meaningful activity, physical activity as a mental activity, quality of life and recovery, and perceived challenges to physical activity. The unique perspectives of service users provides fresh insights on the topic and the findings support the justification for the inclusion of physical activity in plans of care and to be contained in global mental health policy directives. © 2014 John Wiley & Sons Ltd.

Do More of Those in Misery Suffer from Poverty, Unemployment or Mental Illness?

PubMed Central

Flèche, Sarah

2017-01-01

SUMMARY Studies of deprivation usually ignore mental illness. This paper uses household panel data from the USA, Australia, Britain and Germany to broaden the analysis. We ask first how many of those in the lowest levels of life-satisfaction suffer from unemployment, poverty, physical ill health, and mental illness. The largest proportion suffers from mental illness. Multiple regression shows that mental illness is not highly correlated with poverty or unemployment, and that it contributes more to explaining the presence of misery than is explained by either poverty or unemployment. This holds both with and without fixed effects. PMID:28729747

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

PubMed

Wynaden, Dianne; Heslop, Brett; Heslop, Karen; Barr, Lesley; Lim, Eric; Chee, Gin-Liang; Porter, James; Murdock, Jane

2016-12-01

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. © 2016 Australian College of Mental Health Nurses Inc.

Reliability and Validity of a Measure of Sexual and Physical Abuse Histories among Women with Serious Mental Illness.

ERIC Educational Resources Information Center

Meyer, Ilan H.; And Others

1996-01-01

Structured clinical interviews concerning childhood histories of physical and sexual abuse with 70 mentally ill women at 2 times found test-retest reliability of .63 for physical abuse and .82 for sexual abuse. Validity, assessed as consistency with an independent clinical assessment, showed 75% agreement for physical abuse and 93% agreement for…

The attitudes of general hospital doctors toward patients with comorbid mental illness.

PubMed

Noblett, Joanne E; Lawrence, Robert; Smith, Jared G

2015-01-01

What are the attitudes of general hospital doctors toward patients with comorbid mental illness? Do certain characteristics of the health professional related to attitude valence to patients with comorbid mental illness? An anonymous questionnaire was sent out to a cohort of doctors working in three General Hospitals in South West London. The questionnaire included vignettes to assess the respondents' attitudes toward eight patients presenting with a physical compliant with different clinical histories, including depression, schizophrenia, personality disorder, diabetes, and criminal behavior. A total of 52 participants completed the questionnaire; 40 females and 12 males. Across all domains, the most positive attitudes were held toward patients without a diagnosis of mental illness. The least positive attitudes were toward patients with schizophrenia, personality disorder, and those classified as "criminals," and negative attitudes relating to the unpredictability of patients was identified in these categories. There was no statistically significant difference in attitudes depending on age or level of training. However, female participants tended to endorse more positive attitudinal responses, most clearly toward patients with depression and heroin addiction. Negative attitudes of doctors were identified toward certain mental illness diagnoses and are likely to contribute the physical health disparity between patients with and without a comorbid mental illness. This raises the question as to how these attitudes can be changed in order to improve the parity of physical health care between patient with and without mental illness. © The Author(s) 2015.

Care giving of people with severe mental illness: an Indian experience.

PubMed

Janardhana, Navaneetham; Raghunandan, Shravya; Naidu, Dodala Muniratnam; Saraswathi, L; Seshan, Valli

2015-01-01

Caring is a fundamental issue in the rehabilitation of a person with mental illness and more so for people with severe mental illness. The lack of adequate manpower resources in the country is adding and enlisting the responsibility of providing care on the families to provide physical, medical, social and psychological care for their severely unwell mentally ill people. To examine the load of caregiving with reference to the types of care during the symptomatic and remission phases of severe mental illness and the various ways in which caregivers adapt their lives to meet the needs of people with severe mental illness. The present research draws its data from the 200 families with mental illness in Andra Pradesh and Karnataka in India. The data presented in the study was collected from interviews using an interview schedule with open-ended questions. The study diffuses the notion of 'care' as 'physical', 'medical, 'psychological' and 'social' care. The present article focuses on the caregiving roles of the caregivers of people with schizophrenia, affective disorders and psychosis not otherwise specified (NOS) and found that the caregiving does not differ much between the different diagnosis, but caregiving roles changes from active involvement in physical and medical care to more of social and psychological care during the remission. The study records the incredulous gratitude of caregivers at being acknowledged for the work they do. In that regard, the study itself provides a boost to the morale of tired, unacknowledged caregivers.

Comparing physical and mental health literacy.

PubMed

Vimalanathan, Adshara; Furnham, Adrian

2018-04-27

This study attempted to ascertain whether people had better mental vs physical health literacy by comparing their knowledge of six conditions. The aim was to link two different literatures which have remained apart. In all, 186 young British participants (52% male) with an average age of 25 years completed an online questionnaire describing six vignettes characters. Three described mental health conditions (anorexia, bipolar disorder and schizophrenia) and three physical health conditions (asthma, diabetes and osteoarthritis). Participants were required to name the illness and rate how treatable and manageable they believed the condition is. They were also asked to rate how much the problem would affect an individual's daily life and suggest whether the individual should seek professional help. The recognition of specific mental health conditions (anorexia, borderline personality disorder, schizophrenia) was marginally higher than the recognition of physical health conditions (arthritis, asthma, diabetes). Ratings about treatment and the effect of each illness showed considerable variation. The results suggest that people are equally and relatively poorly informed about relatively common mental compared to physical illnesses.

Adherence to physical activity recommendations and physical and mental health risk in people with severe mental illness in Uganda.

PubMed

Vancampfort, Davy; Probst, Michel; Basangwa, David; De Hert, Marc; Myin-Germeys, Inez; van Winkel, Ruud; Ward, Philip B; Rosenbaum, Simon; Mugisha, James

2017-11-29

This study investigated cardio-metabolic risk factors among patients with severe mental illness who do or do not meet the recommendations of 150min per week of physical activity. A secondary aim was to assess whether those that do meet the recommendations report lower levels of mental health symptoms. 107 (60♀) Ugandan in- and outpatients (mean age=34.4 ± 9.7 years) with severe mental illness (depression=7, bipolar disorder=55, schizophrenia=45) completed the Physical Activity Vital Sign (PAVS) method and Brief Symptoms Inventory -18. Participants were also screened for abdominal obesity (waist circumference>90cm), overweight (body mass index≥25) and hypertension (systolic pressure≥140mmHg and/or diastolic pressure≥90mmHg).48.6% (n = 52) of patients met the physical activity recommendations as assessed by the PAVS method. 41.1% (n = 44) were overweight, 40.2% (n = 43) had abdominal obesity and 23.4% (n = 25) had hypertension. Those who did not meet the physical activity recommendations were significantly older, had a higher BSI-18 somatisation score, and had a higher risk of overweight [relative risk (RR) = 2.88, 95% confidence interval (CI) = 1.59-4.99], abdominal obesity (RR = 1.82, 95%CI = 1.13-2.93), and hypertension (RR = 2.16, 95%CI = 0.99-4.73). The PAVS is a feasible method of assessing physical activity among patients with severe mental illness in a low resource setting. The PAVS may have clinical utility for physical and mental health risk stratification. Copyright © 2017 Elsevier B.V. All rights reserved.

Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective.

PubMed

Rosenbaum, Simon; Tiedemann, Anne; Stanton, Robert; Parker, Alexandra; Waterreus, Anna; Curtis, Jackie; Ward, Philip B

2016-02-01

Physical activity (PA) and exercise is increasingly being recognised as an efficacious component of treatment for various mental disorders. The association between PA and cardiometabolic disease is well established, as is the strong link between mental illness, sedentary behaviour and poor cardiometabolic health. Examples of successful integration of clinical PA programs within mental health treatment facilities are increasing. The aim of this review was to summarise the evidence regarding PA and mental illness, and to present examples of clinical exercise programs within Australian mental health facilities. A narrative synthesis of systematic reviews and clinical trials was conducted. Evidence supporting the inclusion of PA programs as an adjunct to treatment for various conditions was presented; including depression, schizophrenia, anxiety disorders, post-traumatic stress disorder and substance abuse. In light of the available evidence, the inclusion of clinical PA programs within mental health treatment, facilitated by dedicated clinicians (exercise physiologists / physiotherapists) was justified. PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Screening physical health? Yes! But...: nurses' views on physical health screening in mental health care.

PubMed

Happell, Brenda; Scott, David; Nankivell, Janette; Platania-Phung, Chris

2013-08-01

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken. © 2013 John Wiley & Sons Ltd.

A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model.

PubMed

Baines, Tineke; Wittkowski, Anja

2013-09-01

Psychologists have utilised a range of social cognition models to understand variation in physical health and illness-related behaviours. The most widely studied model of illness perceptions has been the Self-Regulation Model (SRM, Leventhal, Nerenz, & Steele, 1984). The illness perceptions questionnaire (IPQ) and its revised version (IPQ-R) have been utilised to explore illness beliefs in physical health. This review examined 13 quantitative studies, which used the IPQ and IPQ-R in mental health in their exploration of illness perceptions in psychosis, bipolar disorder, eating disorders, depression and adolescents experiencing mood disorders. Across these studies the SRM illness dimensions were largely supported. Mental illnesses were commonly viewed as cyclical and chronic, with serious negative consequences. Perceptions regarding chronicity, controllability and negative consequences were associated with coping and help seeking, while engagement with services and help seeking were also related to illness coherence beliefs. Treatment adherence was linked to beliefs that treatment could control one's illness. Whilst a major limitation of the reviewed studies was the use of cross-sectional designs, overall the applicability of the SRM to mental health was supported. The IPQ and IPQ-R were shown to be valuable measures of illness perceptions in mental health, offering implications for clinical practice.

The Singaporean public beliefs about the causes of mental illness: results from a multi-ethnic population-based study.

PubMed

Pang, S; Subramaniam, M; Lee, S P; Lau, Y W; Abdin, E; Chua, B Y; Picco, L; Vaingankar, J A; Chong, S A

2017-04-03

To identify the common causal beliefs of mental illness in a multi-ethnic Southeast Asian community and describe the sociodemographic associations to said beliefs. The factor structure to the causal beliefs scale is explored. The causal beliefs relating to five different mental illnesses (alcohol abuse, depression, obsessive-compulsive disorder (OCD), dementia and schizophrenia) and desire for social distance are also investigated. Data from 3006 participants from a nationwide vignette-based study on mental health literacy were analysed using factor analysis and multiple logistic regression to address the aims. Participants answered questions related to sociodemographic information, causal beliefs of mental illness and their desire for social distance towards those with mental illness. Physical causes, psychosocial causes and personality causes were endorsed by the sample. Sociodemographic differences including ethnic, gender and age differences in causal beliefs were found in the sample. Differences in causal beliefs were shown across different mental illness vignettes though psychosocial causes was the most highly attributed cause across vignettes (endorsed by 97.9% of respondents), followed by personality causes (83.5%) and last, physical causes (37%). Physical causes were more likely to be endorsed for OCD, depression and schizophrenia. Psychosocial causes were less often endorsed for OCD. Personality causes were less endorsed for dementia but more associated with depression. The factor structure of the causal beliefs scale is not entirely the same as that found in previous research. Further research on the causal beliefs endorsed by Southeast Asian communities should be conducted to investigate other potential causes such as biogenetic factors and spiritual/supernatural causes. Mental health awareness campaigns should address causes of mental illness as a topic. Lay beliefs in the different causes must be acknowledged and it would be beneficial for the public to be informed of the causes of some of the most common mental illnesses in order to encourage help-seeking and treatment compliance.

Barriers to involvement in physical activities of persons with mental illness.

PubMed

Shor, Ron; Shalev, Anat

2016-03-01

Participating in physical activities could be essential for reducing the multiple risk factors for health problems that persons with severe mental illness (SMI) may suffer. However, people with SMI are significantly less active than the general population. To develop knowledge about factors related to the perceived barriers hindering this population's participation in physical activities and the benefits this participation would have, a study was conducted in Israel with 86 people with mental illness living in community mental health facilities prior to their participation in a health promotion program. A mixed method was implemented and included: a scale designed to measure participants' perceptions of the barriers to and benefits of involvement in physical activities; instruments focusing on bio-psycho-social factors that may affect the level of barriers experienced; and personal interviews. The findings revealed high ranking for accessibility barriers hindering the participation in physical activities. Bio-psycho-social factors stemming from the participants' mental health, such as level of depression, were correlated with higher ranking of accessibility barriers. Bio-psycho-social factors reflecting positive mental health and health, such as positive appraisal of body weight, were correlated with lower ranking of accessibility barriers. Other barriers may include organizational and broader systemic barriers in the mental health facilities where the participants reside. These findings illuminate the need to consider the unique challenges that persons with mental illness may face in any attempt to advance their involvement in physical activity. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study.

PubMed

Hatch, Stephani L; Frissa, Souci; Verdecchia, Maria; Stewart, Robert; Fear, Nicola T; Reichenberg, Abraham; Morgan, Craig; Kankulu, Bwalya; Clark, Jennifer; Gazard, Billy; Medcalf, Robert; Hotopf, Matthew

2011-11-11

Responses to public health need require information on the distribution of mental and physical ill health by demographic and socioeconomic factors at the local community level. The South East London Community Health (SELCoH) study is a community psychiatric and physical morbidity survey. Trained interviewers conducted face-to-face computer assisted interviews with 1698 adults aged 16 years and over, from 1076 randomly selected private households in two south London boroughs. We compared the prevalence of common mental disorders, hazardous alcohol use, long standing illness and general physical health by demographic and socioeconomic indicators. Unadjusted and models adjusted for demographic and socioeconomic indicators are presented for all logistic regression models. Of those in the sample, 24.2% reported common mental disorder and 44.9% reported having a long standing illness, with 15.7% reporting hazardous alcohol consumption and 19.2% rating their health as fair or poor. The pattern of indicators identifying health inequalities for common mental disorder, poor general health and having a long term illness is similar; individuals who are socioeconomically disadvantaged have poorer health and physical health worsens as age increases for all groups. The prevalence of poor health outcomes by ethnic group suggests that there are important differences between groups, particularly for common mental disorder and poor general health. Higher socioeconomic status was protective for common mental disorder, fair or poor health and long standing illness, but those with higher socioeconomic status reported higher levels of hazardous alcohol use. The proportion of participants who met the criteria for common mental disorder with co-occurring functional limitations was similar or greater to those with poor physical health. Health service providers and policy makers should prioritise high risk, socially defined groups in combating inequalities in individual and co-occurring poor mental and physical problems. In population terms, poor mental health has a similar or greater burden on functional impairment than long term conditions and perceived health.

Why are people with mental illness excluded from the rational suicide debate?

PubMed

Hewitt, Jeanette

2013-01-01

The topic of rational suicide is often approached with some trepidation by mental health professionals. Suicide prevention strategies are more likely to be seen as the domain of psychiatry and a wealth of psychiatric literature is devoted to identifying and managing suicide risk. Whether or not suicide can be deemed permissible is ostensibly linked to discussions of autonomy and mental capacity, and UK legislation directs that a patient's wishes must be respected with regard to treatment refusal where decisional capacity is intact. In the context of the care and treatment of those with physical disorders, extreme and untreatable physical suffering is likely to be accepted as rational grounds for suicide, where the person possesses cognitive coherence and an ability to realistically appreciate the consequences of his or her actions. In the case of those with serious mental disorder, the grounds for accepting that suicide is rational are however less clear-cut. Serious mental illness is typically conceived of as a coercive pressure which prevents rational deliberation and as such, the suicides of those with serious mental illness are considered to be substantially non-voluntary acts arising from constitutive irrationality. Therefore, where an appropriate clinician judges that a person with serious mental disorder is non-autonomous, suicide prevention is likely to be thought legally and morally justified. There are arguably, two questionable assumptions in the position that psychiatry adopts: Firstly, that psychogenic pain is in some way less real than physical pain and secondly, that mental illness invariably means that a desire to die is irrational and inauthentic. If it can be shown that some people with serious mental illness can be rational with regard to suicide and that psychological pain is of equal significance as physical suffering, then it may be possible to conclude that some persons with serious mental illness should not by definition be excluded from the class of those for whom rational suicide may be a coherent choice. Copyright © 2013 Elsevier Ltd. All rights reserved.

The value of physical examination in mental health nursing.

PubMed

Martin, Carolyn T

2016-03-01

This article explores the use of a physical examination assignment in a mental health general nursing clinical placement course that addresses the poor physical health of people with mental illness and the barriers traditionally impeding health care provision for this population. A descriptive qualitative approach utilizes inductive content analysis to investigate 145 student survey responses. The assignment assists student nurses in understanding that physical and mental well-being are intrinsically linked. Students report increased comfort performing a physical examination on patients with mental illness post assignment. Students' initial bias towards this population was minimized post the clinical assignment. Poor physical health is common among people with mental health problems. Many view the provision of care as a major public health issue. Nurses are the front line caregivers of mental health service consumers and are well positioned to assess their physical needs. Their assessment may be the first step in recognizing health care issues in this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Employees' perspectives on ethically important aspects of genetic research participation: a pilot study.

PubMed

Roberts, Laura Weiss; Warner, Teddy D; Geppert, Cynthia M A; Rogers, Melinda; Green Hammond, Katherine A

2005-01-01

Insights from genetic research may greatly improve our understanding of physical and mental illnesses and assist in the prevention of disease. Early experience with genetic information suggests that it may lead to stigma, discrimination, and other psychosocial harms, however, and this may be particularly salient in some settings, such as the workplace. Despite the importance of these issues, little is known about how healthy adults, including workers, perceive and understand ethically important issues in genetic research pertaining to physical and mental illness. We developed, pilot tested, and administered a written survey and structured interview to 63 healthy working adults in 2 settings. For this paper, we analyzed a subset of items that assessed attitudes toward ethically relevant issues related to participation in genetic research on physical and mental illness, such as its perceived importance, its acceptability for various populations, and appropriate motivations for participation. Our respondents strongly endorsed the importance of physical and mental illness genetic research. They viewed participation as somewhat to very acceptable for all 12 special population groups we asked about, including persons with mental illness. They perceived more positives than negatives in genetic research participation, giving neutral responses regarding potential risks. They affirmed many motivations for participation to varying degrees. Men tended to affirm genetic research participation importance, acceptability, and motivations more strongly than women. Healthy working persons may be willing partners in genetic research related to physical and mental illnesses in coming years. This project suggests the feasibility and value of evidence-based ethics inquiry, although further study is necessary. Evidence regarding stakeholders' perspectives on ethically important issues in science may help in the development of research practices and policy.

Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries.

PubMed

Bressington, Daniel; Badnapurkar, Ashish; Inoue, Sachiko; Ma, Hin Yeung; Chien, Wai Tong; Nelson, Deborah; Gray, Richard

2018-02-15

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses' attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses' attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI.

Coping strategies of caregivers towards aggressive behaviors of persons with severe mental illness.

PubMed

Madathumkovilakath, Neethu Bhaskaran; Kizhakkeppattu, Sindhu; Thekekunnath, Saleem; Kazhungil, Firoz

2018-04-24

Aggression is one of the chief determinants of caregiver burden in severe mental illnesses. Clinical and treatment implications of aggression in mental illness are predominantly studied in perspectives of mental health care professionals. Coping style of caregivers towards aggression of persons with mental illness is understudied. So we studied coping strategies used by caregivers of patients with severe mental illness towards aggressive behaviors of patients and relationship between aggressive behavior and coping strategies. We assessed two hundreds and seventy caregivers of patients with severe mental illness attending outpatient psychiatry department using Modified Overt Aggression Scale and the Ways of Coping Scale - revised. 95.6% of the caregivers perceived verbal aggression followed by aggression against property (67%), auto aggression (33.7%) and physical aggression (25.6%). The study revealed that adaptive coping strategies - planful problem solving and seeking social support were used by 40% each of caregivers to deal with aggressive behavior. Only 4.4% of caregivers resorted to escape avoidance which is maladaptive coping strategy. Though adaptive strategies were used by caregivers these were not used in appropriate situations. Physical aggression and aggression against property were not significantly associated with planful problem solving (r = 0.105; p = 0.08 and r = 0.110; p = 0.07 respectively). But verbal aggression, aggression against property and physical aggression were associated with escape avoidance (r = 0.152; p = 0.01 and r = 0.168; p = 0.01 and r = 0.23; p = <0.001 respectively). The study concluded that coping in caregivers of severe mental illness is maladaptive with respect to aggression. Coping skills training would play a major role to address this issue. Copyright © 2018 Elsevier B.V. All rights reserved.

Illness appraisals and health-related quality of life in adolescents and young adults with allergies and asthma.

PubMed

Hullmann, Stephanie E; Eddington, Angelica R; Molzon, Elizabeth S; Mullins, Larry L

2013-01-01

The current study sought to: 1) assess differences in levels of physical and mental health-related quality of life (HRQOL), illness uncertainty, and intrusiveness in adolescents and young adults (AYAs) with allergies and asthma, as well as 2) examine the effect of illness appraisals on HRQOL. Participants were undergraduate students with self-reported allergies (n=74) and asthma (n=74) who completed the Mishel Uncertainty in Illness Scale (MUIS), the Illness Intrusiveness Scale (IIS), and the SF-36 Health Survey Questionnaire. Paired t-tests indicated that AYAs with allergies reported higher levels of illness uncertainty and poorer mental HRQOL than AYAs with asthma; the groups did not differ on reported levels of illness intrusiveness or physical HRQOL. Hierarchical regressions were conducted to examine the relationship between illness appraisals and HRQOL. Results revealed that poorer mental HRQOL was associated with higher illness uncertainty in AYAs with allergies and higher illness intrusiveness in AYAs with asthma. Poorer physical HRQOL was associated with higher illness uncertainty in AYAs with asthma and higher illness intrusiveness in AYAs with allergies and asthma. The current examination suggests that illness appraisals may be differentially related to HRQOL in AYAs with allergies compared to those with asthma.

The impact of adverse health events on consumption: Understanding the mediating effect of income transfers, wealth, and health insurance.

PubMed

Babiarz, Patryk; Yilmazer, Tansel

2017-12-01

Using data from the Panel Study of Income Dynamics for years 1999-2013, we investigate the impact of physical and mental illnesses on household consumption and financial status. In comparison to severe physical health problems, mental illnesses lead to larger decreases in labor income. Increases in public and private transfers following the onset of a mental illness do not completely offset the decline in labor income. Consequently, we find a significant decrease in consumption expenditures after the household head experiences a mental problem. On the other hand, public and private transfers and accumulated wealth offset the relatively smaller decline in labor income and enable households with severe physical problems to smooth their consumption. Health insurance helps to prevent larger drops in consumption after the onset of a mental health problem. Copyright © 2017 John Wiley & Sons, Ltd.

Physical activity and mental disorders: a case-control study on attitudes, preferences and perceived barriers in Italy.

PubMed

Carpiniello, Bernardo; Primavera, Diego; Pilu, Alessandra; Vaccargiu, Nicola; Pinna, Federica

2013-12-01

Mentally ill people experience greater difficulty than the general population in exercising regularly. We aimed to evaluate attitudes displayed and barriers perceived towards physical activity in a sample of psychiatric patients. A total of 138 (M = 48, F = 90) patients attending a community mental health centre were compared with a control group made up of 138 subjects not affected by mental disorders matched for gender, mean age and education. Both groups underwent a self-administered questionnaire. Patients reported a more sedentary lifestyle in terms of weekly physical activities and daily hours of exercise; their body mass index (BMI) was significantly higher compared with the BMI of controls (p < 0.002); the mentally ill more frequently reported tiredness (p < 0.001), scarce motivation (p < 0.001) and the illness itself (p = 0.01) as barriers to physical activity; moreover, stating how feeling sad or "distressed" reduced their propensity to physical exercise (p = 0.002). A higher number of patients (p < 0.0001) reported little or no motivation for physical activity, and the experiencing of scarce enjoyment (p < 0.001). A series of barriers may limit regular physical activity in subjects affected by mental disorders; these barriers should be taken into account and appropriately addressed.

Disability and treatment of psychiatric and physical disorders in South Africa.

PubMed

Suliman, Sharain; Stein, Dan J; Myer, Landon; Williams, David R; Seedat, Soraya

2010-01-01

We aimed to compare disability rates associated with physical disorders versus psychiatric disorders and to establish treatment rates of both classes of disorder in the South African population. In a nationally representative survey of 4351 adults, treatment and prevalence rates of a range of physical and psychiatric disorders, and their associated morbidity during the previous 12 months were investigated. Physical illnesses were reported in 55.2% of the sample, 60.4% of whom received treatment for their disorder. Approximately 10% of the samples show a mental illness with 6.1% having received treatment for their disorder. The prevalence of any mental illness reported was higher than that reported individually for asthma, cancer, diabetes, and peptic ulcer. Mental disorders were consistently reported to be more disabling than physical disorders and the degree of disability increased as the number of comorbid disorders increased. Depression, in particular, was rated consistently higher across all domains than all physical disorders. Despite high rates of mental disorders and associated disability in South Africa, they are less likely to be treated than physical disorders.

Disability and Treatment of Psychiatric and Physical Disorders in South Africa

PubMed Central

Suliman, Sharain; Stein, Dan J; Myer, Landon; Williams, David R; Seedat, Soraya

2011-01-01

We aimed to compare disability rates associated with physical disorders versus psychiatric disorders and to establish treatment rates of both classes of disorder in the South African population. In a nationally representative survey of 4351 adults, treatment and prevalence rates of a range of physical and psychiatric disorders, and their associated morbidity during the previous 12 months were investigated. Physical illnesses were reported in 55.2% of the sample, 60.4% of whom received treatment for their disorder. Approximately 10% of the sample endorsed a mental illness with 6.1% having received treatment for their disorder. The prevalence of any mental illness reported was higher than that reported individually for asthma, cancer, diabetes and peptic ulcer. Mental disorders were consistently reported to be more disabling than physical disorders and the degree of disability increased as the number of comorbid disorders increased. Depression, in particular, was rated consistently higher across all domains than all physical disorders. Despite high rates of mental disorders and associated disability in South Africa, they are less likely to be treated than physical disorders. PMID:20061863

Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services.

PubMed

Blomqvist, Marjut; Sandgren, Anna; Carlsson, Ing-Marie; Jormfeldt, Henrika

2018-02-01

It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.

The role of physical and mental health multimorbidity in suicidal ideation.

PubMed

Kavalidou, Katerina; Smith, Daniel J; O'Connor, Rory C

2017-02-01

Previous research has focused on the separate roles of mental illness and physical health conditions in suicide risk, with relatively few studies investigating the importance of physical and psychiatric disorder co-occurrence. We aimed to investigate whether suicidal ideation might be influenced by physical and mental ill-health multimorbidity. Data from the Adult Psychiatric Morbidity Survey of England were analysed. Participants who responded to the suicidal thoughts question were grouped into four distinct categories based on their health conditions (Common mental disorders (CMD) only, physical health conditions only, CMD/physical health multimorbidity and a control group with neither physical nor mental health conditions). Multinomial logistic regression analyses were conducted and odds ratios (OR) and 95% CIs are presented. In the fully adjusted model, both the multimorbidity and CMD-only groups were associated with higher levels of suicidal ideation relative to the control group. Secondary analyses of cross-sectional data. Although multimorbidity was associated with suicidal thoughts, it does not appear to elevate risk beyond the independent effects of common mental disorders or physical health problems. Primary care and mental health clinicians should consider assessment of suicidal ideation among patients with multimorbid physical/mental health conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Physics of Intrinsic and Extrinsic Factors that Cause the Onset of the Deadliest Illness of Mankind and are Important for Diagnostics and Treatment

NASA Astrophysics Data System (ADS)

Saxena, Arjun

One of the most important topic of research in the field of Physics of Behavior is the deadliest illness of mankind which is the group of illnesses called mental illnesses. They are getting attention increasingly worldwide by the medical communities and their respective governments, because of the following fact. It is now well established that these illnesses cause more loss of human lives, destruction of families, businesses and overall economy than all the other illnesses combined. The purpose of this paper is to identify and provide solutions to two fundamental issues of such illnesses which still remain as problems. One is the stigma associated with them because of their name ``mental''. The patients are regarded as less than normal because their illness is only ``mental'' in origin. The second is that it is still not widely recognized that they are caused by medical problems in their ``brain'' which afflict their ``mind''. This paper explains this and gives an improved 3-D model using the physics of intrinsic and extrinsic factors of both ``brain'' and ``mind''. It leads to an important new name, ``BAMI'' (Brain and Mind Illness), which eliminates the stigma and gives quantitative parameters to diagnose the illness and monitor medicines to treat such illnesses.

[Psychological benefits of physical activity for optimal mental health].

PubMed

Poirel, Emmanuel

Mental health is a worldwide public health concern, as can be seen from the WHO's comprehensive mental health action plan 2013-2020 which was adopted by the 66th World Health Assembly. According to the Mental health commission of Canada (2012), one in five Canadians will personally experience a mental illness in their lifetime, and the WHO shows that mental illness represents the second most prevalent risk of morbidity after heart disease. Physical activity certainly provides an answer to this problem. Physical activity has been shown to improve physical health but it is also one of the most natural and accessible means to improve mental health. The aim of the present article is to propose a biopsychosocial model on the basis of a literature review on the psychological benefits of physical activity. In view of the findings we assume that physical activity increases mental well-being and optimal mental health as opposed to poor mental health. Hence, physical activity provides a state of well-being that enables individuals to realize their own potential, and that helps to cope with the normal stresses of life or adversity. The model certainly opens the way for research and new hypothesis, but it also aims at the promotion of the benefits of physical activity on psychological well-being for optimal mental health.

An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

PubMed

Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

2014-12-30

The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

Quality of life in people with mental illness in non-residential community mental health services in Hong Kong.

PubMed

Ng, P; Pan, J Y; Lam, P; Leung, A

2014-06-01

To identify the subjective quality of life in people with chronic mental health problems who were in non-residential community mental health services, and to investigate factors affecting their quality of life after the illness. People with mental illness (n = 105) were recruited. They were assessed with the self-rated Hong Kong Chinese version of the World Health Organization Quality of Life Brief questionnaire. The participants had lower total quality-of-life and the 4 domain scores of the questionnaire than the general population. They were particularly dissatisfied with their financial situation. Duration of illness was positively correlated with subjective quality-of-life variables while age at onset of the mental illness was negatively correlated with subjective quality of life, in particular the physical health, psychological health, and environmental domains. This study highlighted the significance of duration and age at onset of illness in subjective quality of life of people with mental illness. A longitudinal study to test the causal relationships between these factors and the quality of life in people with mental illness is recommended.

Mentally Ill Children.

ERIC Educational Resources Information Center

Blai, Boris, Jr.

Estimates suggest that about 15% of all children have some form of mental disturbance. Potential causes can be of a physical, psychological, or environmental origin. Symptoms which indicate that a child needs professional help usually involve emotional overreaction to changes. Diagnosis of a child evidencing symptoms of mental illness should take…

Physical Health Care for People with Severe Mental Illness: the Attitudes, Practices, and Training Needs of Nurses in Three Asian Countries

PubMed Central

Badnapurkar, Ashish; Ma, Hin Yeung; Nelson, Deborah

2018-01-01

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses’ attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses’ attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI. PMID:29462859

Quality of Life Outcomes in Community-based Mental Health Consumers: Comparisons with Population Norms and Changes over Time.

PubMed

Happell, Brenda; Stanton, Robert; Hodgetts, Danya; Scott, David

2016-01-01

Quality of life is shown to be lower in people diagnosed with mental illness in comparison to the general population. The aim of this study is to examine the Quality of life in a subset of people accessing mental health services in a regional Queensland Centre. Thirty-seven people accessing mental health services completed the SF36 Health Survey on three occasions. Differences and relationships between Physical Composite Scores and Mental Composite Scores, comparisons with Australian population norms, and temporal change in Quality of Life were examined. Physical Composite Scores were significantly different to, but significantly correlated with, Mental Composite Scores on each occasion. Physical Composite Scores and Mental Composite Scores were significantly different to population norms, and did not vary significantly across time. The poor Quality of life of people with mental illness remains a significant challenge for the mental health workforce.

Does section 63 of the Mental Health Act 1983 disempower patients with mental illness? Analysis of the case law.

PubMed

Senasinghe, Bhanuka

2018-03-01

In England and Wales, detained psychiatric inpatients are treated under section 63 of the Mental Health Act 1983. This paper critically analyses the relevant law and considers the arbitrary distinctions between consent for treatments for mental illnesses and physical conditions, which may disempower patients with mental illness. Section 63 states that (for detained psychiatric patients) consent for medical treatment for patients' mental disorder is not required. The treating clinician responsible for a patient decides what this medical treatment entails. This article focuses on three main legal cases: B v Croydon Health Authority, Tameside and Glossop v CH and Nottinghamshire Healthcare NHS Trust v RC and considers whether s 63 disempowers patients with mental illnesses.

Social and material aspects of life and their impact on the physical health of people diagnosed with mental illness.

PubMed

Ewart, Stephanie B; Happell, Brenda; Bocking, Julia; Platania-Phung, Chris; Stanton, Robert; Scholz, Brett

2017-10-01

People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts. To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health-care services. Qualitative exploratory design involving focus groups. The research was conducted in the Australian Capital Territory. Participants were consumers of mental health services. The Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts. Issues impacting consumers included poverty, the neglect of public services and being treated as second-class citizens because of diagnosis of mental illness and/or experiencing a psychosocial disability. These factors were connected with significant barriers in accessing physical health care, including the quality and relevance of health provider communication, especially when the broader contexts of mental health consumer's lives are not well understood. These findings suggest the Commission on Social Determinants of Health Framework could be utilized in research and policy, and may provide an effective platform for exploring better health communication with mental health consumers regarding this neglected health inequity. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Ageing and mental health: changes in self-reported health due to physical illness and mental health status with consecutive cross-sectional analyses.

PubMed

Lorem, Geir Fagerjord; Schirmer, Henrik; Wang, Catharina E A; Emaus, Nina

2017-01-18

It is known that self-reported health (SRH) declines with increasing age and that comorbidity increases with age. We wished to examine how age transfers its effect to SRH through comorbid disease and mental illness and whether these processes remained stable from 1994 until 2008. The hypothesis is that ageing and/or the increased age-related burden of pathology explains the declining SRH. The Tromsø Study (TS) is a cohort study using a survey approach with repeated physical examinations. It was conducted in the municipality of Tromsø, Norway, from 1974 to 2008. A total of 21 199 women and 19 229 men participated. SRH is the outcome of interest. We calculated and compared the effect sizes of age, comorbidity and mental health symptoms using multimediator analysis based on OLS regression. Ageing had a negative impact on SRH, but the total effect of age decreased from 1994 to 2007. We assessed the direct effect of age and then the proportion of indirect age-related effects through physical illness and mental health symptoms on the total effect. The direct effect of age represented 79.3% of the total effect in 1994 and decreased to 58.8% in 2007. Physical illness emerged as an increasingly important factor and increased its influence from 15.7% to 41.2% of the total effect. Age alone had a protective effect on mental health symptoms and this increased (2.5% to 17.3%), but we found a stronger association between mental health symptoms and physical disease in the later waves of the study (increasing from 3.7% to 14.8%). The results suggest that the effect on SRH of mental health symptoms caused by physical illness is an increasing public health problem. Treatment and care for specific medical conditions must therefore focus more strongly on how these conditions affect the patient's mental health and address these concerns accordingly. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Newspaper depictions of mental and physical health.

PubMed

Chen, Marian; Lawrie, Stephen

2017-12-01

Aims and method Media portrayals of mental illness have long been recognised as being misleading and stigmatising. Following the campaigns of several advocacy groups to address this issue, we aimed to evaluate the impact on mental health reporting over time. We repeated a survey we did 15 years ago using the same methods. Nine UK daily newspapers were surveyed over a 4-week period and coded with a schema to analyse the reporting of mental health compared with physical health. Results In total, 963 articles - 200 on mental health and 763 on physical health - were identified. Over half of the articles on mental health were negative in tone: 18.5% indicated an association with violence compared with 0.3% of articles on physical health. However, there were more quotes from patients with mental disorders than physical disorders (22.5% v. 19.7%) and an equal mention of treatment and rehabilitation. Clinical implications Mental health in print media remains tainted by themes of violence, however some improvement in reporting in recent years is evident, in particular by providing a voice for people with mental illness.

Health Behaviors, Knowledge, Life Satisfaction, and Wellbeing in People with Mental Illness across Four Countries and Comparisons with Normative Sample.

PubMed

Parletta, Natalie; Aljeesh, Yousef; Baune, Bernhard T

2016-01-01

People with chronic mental illness have poorer physical health and higher mortality than the general population. We investigated lifestyle factors in people with mental illness across four countries and compared with a normative sample. Data were collected from N = 672 people (Germany, n = 375; Palestine, n = 192; London, n = 63; Australia, n = 42) with substance abuse disorder (n = 224), schizophrenia (n = 158), mood disorders (n = 227), and somatoform disorders (n = 63). The General Health Behaviour Questionnaire measured behaviors and knowledge related to nutrition, physical activity, alcohol, smoking, sleep, life satisfaction, and wellbeing. The normative samples were derived from a German population (N = 1,019). Data were analyzed using ANOVAs and t-tests. The Palestine sample did not differ from the Western samples on reported life satisfaction and wellbeing. However, they reported unhealthier diets, less physical activity, and lower knowledge about the impact of diet, physical activity, smoking, and sleep on health than the Western samples. Comparing the Western and normative samples, people with mental illness reported lower intake of healthy foods/drinks, higher intake of unhealthy foods, higher exercise, higher alcohol consumption, less cigarettes, less sleep, and more sleep problems. Their knowledge was lower for nutrition, physical activity, and smoking. All participants reported lower life satisfaction and wellbeing than the normative sample (P-values <0.001). Education on health-related lifestyle factors present important targets for primary care, quality of life and prevention of illness in people with mental illness. Further research will clarify specific predictors of health behaviors in each country.

Inequalities in healthcare provision for people with severe mental illness.

PubMed

Lawrence, David; Kisely, Stephen

2010-11-01

There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.

Bereavement

MedlinePlus

... as a mental, physical, social or emotional reaction. Mental reactions can include anger, guilt, anxiety, sadness and despair. Physical reactions can include sleeping problems, changes in appetite, physical problems or illness. How long bereavement lasts can depend on how ...

The effects of undertreated chronic medical illnesses in patients with severe mental disorders.

PubMed

Fagiolini, Andrea; Goracci, Arianna

2009-01-01

Severe mental disorders such as bipolar disorder and schizophrenia often co-occur with chronic medical illnesses, especially cardiovascular disease and diabetes. These comorbidities are associated with a more severe course of mental illness, reduced quality of life, and premature mortality. Although the association between mental disorders and physical health complications has long been recognized, medical conditions remain undertreated in clinical psychiatric practice, and the life expectancy for individuals with serious psychiatric disorders is approximately 30% shorter than that of the general US population. Factors that are related to the mental illness (eg, cognitive impairment, reduced ability to function, and a lack of communication skills) as well as factors such as the high cost of medical care may make accessing general health care a difficult task for patients. Even when medical care is received by patients, the quality is often poor, and dangerous illnesses may be undiagnosed and untreated. In addition, harmful side effects of medications used to treat psychiatric disorders, unhealthy habits and lifestyles, and a possible genetic susceptibility to medical conditions increase the likelihood of comorbid physical conditions in patients with severe mental illness. Implementing behavioral interventions into clinical practice may help patients improve their overall health and prevent chronic medical conditions. © Copyright 2009 Physicians Postgraduate Press, Inc.

Allostatic load mediates the impact of stress and trauma on physical and mental health in Indigenous Australians.

PubMed

Sarnyai, Zoltán; Berger, Maximus; Jawan, Isabella

2016-02-01

A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Setting Up a Mental Health Clinic in the Heart of Rural Africa.

PubMed

Enow, Humphrey; Thalitaya, Madhusudan Deepak; Mbatia, Wallace; Kirpekar, Sheetal

2015-09-01

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948). In Africa, mental health issues often come last on the list of priorities for policy-makers & people's attitudes towards mental illness are strongly influenced by traditional beliefs in supernatural causes/remedies. The massive burden attributed to mental illness in these communities, poses a huge moral, cultural/economic challenge and requires a concerted and integrated approach involving policy makers, mental health Practitioners, the general public, service users and their families and other stake holders to reverse the trend. Improving community awareness of mental illness. Change the negative perception of mental illness by the community. Providing a screening/referral pathway for mental illnesses. Providing supervision of patient care. Promote community participation on issues regarding mental health with a view to challenge existing traditional attitudes and beliefs, reduce stigma and promote health seeking behaviour.

28 CFR 35.104 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... illness, and specific learning disabilities. (ii) The phrase physical or mental impairment includes, but..., heart disease, diabetes, mental retardation, emotional illness, specific learning disabilities, HIV... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION ON THE BASIS OF DISABILITY IN STATE AND...

A review of sociocultural factors that may underlie differences in African American and European American anxiety.

PubMed

Hopkins, Patricia D; Shook, Natalie J

2017-06-01

Preliminary evidence indicates there may be differences in the prevalence and severity of anxiety in African Americans and European Americans. A number of sociocultural risk and protective factors have been suggested to contribute to these group differences, such as salience of physical illnesses, discrimination, stigma toward mental illness, religiosity, and ethnic identity. In this paper, the literature concerning each of these factors is reviewed. Overall, the strongest evidence was found for ethnic identity and stigma toward mental illness as factors underlying group differences in anxiety. Ethnic identity and stigma toward mental illness consistently differed by racial group and were associated with anxiety in African Americans. Ethnic identity may buffer against the negative consequences of anxiety, reducing prevalence rates in African Americans. Stigma toward mental illness may decrease African Americans willingness to report anxiety symptoms, reducing overall prevalence rates but increasing the severity of treated cases. The research regarding discrimination, salience of physical illnesses, and religiosity was less clear. Much more research is required, but the findings of this review suggest that future studies should put particular emphasis on stigma toward mental illness and ethnic identity as important factors in understanding African American anxiety outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study.

PubMed

Bressington, Daniel; Mui, Jolene; Hulbert, Sabina; Cheung, Eric; Bradford, Stephen; Gray, Richard

2014-02-27

People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP. ISRCTN12582470.

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew; Mala, Shereen; Bachner, Mick

2010-03-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring as a means of reducing morbidity, mortality and reduction in quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised or quasi-randomised clinical trials focusing on physical health monitoring versus standard care or comparing i) self monitoring vs monitoring by health care professional; ii) simple vs complex monitoring; iii) specific vs non-specific checks iv) once only vs regular checks or v) comparison of different guidance. The authors (GT, AC, SM) independently screened search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. We did not identify any randomised trials which assessed the effectiveness of physical health monitoring in people with serious mental illness. There is no evidence from randomised trials to support current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

42 CFR 51.41 - Access to records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities... individuals with mental illness: (1) An individual who is a client of the P&A system if authorized by that...) The individual, due to his or her mental or physical condition, is unable to authorize the P&A system...

Worker's Compensation: Will College and University Professors Be Compensated for Mental Injuries Caused by Work-Related Stress?

ERIC Educational Resources Information Center

Hasty, Keith N.

1991-01-01

The extent to which college faculty may recover compensation for debilitating mental illness resulting from stressful work-related activities is discussed. General requirements for worker's compensation claims, compensability of stress-related mental and physical illnesses, applicability of these standards to college faculty, and the current state…

The experiences of youth serving as caregivers for mentally ill parents: a background review of the literature.

PubMed

Mechling, Brandy M

2011-03-01

Young caregivers of mentally ill parents are a vulnerable population. These vulnerabilities include risks for developmental issues, poor socialization, and poor school performance. The purpose of this background review of the literature is to explore the experiences of young caregivers of mentally ill parents and detect the gaps in the literature. The guiding research questions were: What is the experience of young caregivers of mentally ill parents? and What is the experience for those who witness or must assist their parent during a crisis? The majority of research has been conducted outside the United States, primarily in the United Kingdom, and studies have focused mostly on young caregivers of parents with physical rather than mental illness. No studies focused on young caregivers who witnessed or assisted their mentally ill parent in crisis. Information gained through this review will add to the body of knowledge for child mental health and build a case for additional research. Copyright 2011, SLACK Incorporated.

Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study.

PubMed

Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E

2017-07-01

How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among stakeholders, and for physiotherapists to be well equipped with skills and knowledge in mental health to facilitate greater involvement. [Lee S, Waters F, Briffa K, Fary RE (2017) Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study. Journal of Physiotherapy 63: 168-174]. Copyright © 2017. Published by Elsevier B.V.

Circumstances of sexual and physical victimization of black psychiatric outpatients.

PubMed Central

Jenkins, E. J.; Bell, C. C.; Taylor, J.; Walker, L.

1989-01-01

A sample of 54 adult psychiatric outpatients, previously identified as victims of sexual or physical assault, were interviewed regarding their childhood and adult victimization experiences. Patients were questioned about the nature of the assaults, their relationship to the perpetrator(s), the number of assaults suffered in each relationship, and whether the assault(s) occurred before or after the onset of their mental illness. Eighty percent of the sample had experienced major physical assault as an adult and 59% had experienced major physical assault as a child; 37% and 31%, respectively, reported major sexual assault as a child and as an adult. Women were more likely than men to report physical and sexual assault as an adult and sexual assault as a child. Childhood assault most often occurred before the onset of the patient's mental illness; whereas, adult sexual assault for women and physical and sexual assault for men was as likely to occur after the onset of the psychiatric disorder, suggesting an increased vulnerability to victimization for the adult mentally ill. PMID:2709427

Holistic health: does it really include mental health?

PubMed

McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Promoting Nature-Based Activity for People With Mental Illness Through the US “Exercise Is Medicine” Initiative

PubMed Central

Jette, Shannon

2016-01-01

Nature-based physical activity programming (e.g., countryside walks, hiking, horseback riding) has been found to be an effective way to help improve the health of people with mental illness. Exercise referral initiatives, whereby health practitioners prescribe exercise in an attempt to prevent or treat chronic illnesses, have helped make such nature-based activities accessible to this population in the United Kingdom and Australia; however, there is a dearth of research related to the most prominent exercise referral program in the United States: Exercise is Medicine. Taking into account the barriers to physical activity faced by people with mental illness, we explore how nature-based programming for this population might be mobilized in the United States through the growing Exercise is Medicine initiative. PMID:26985618

Efficacy of lifestyle interventions in physical health management of patients with severe mental illness.

PubMed

Chacón, Fernando; Mora, Fernando; Gervás-Ríos, Alicia; Gilaberte, Inmaculada

2011-09-19

Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.

An Implicit Measure of Associations with Mental Illness versus Physical Illness: Response Latency Decomposition and Stimuli Differential Functioning in Relation to IAT Order of Associative Conditions and Accuracy

PubMed Central

Mannarini, Stefania; Boffo, Marilisa

2014-01-01

The present study aimed at the definition of a latent measurement dimension underlying an implicit measure of automatic associations between the concept of mental illness and the psychosocial and biogenetic causal explanatory attributes. To this end, an Implicit Association Test (IAT) assessing the association between the Mental Illness and Physical Illness target categories to the Psychological and Biologic attribute categories, representative of the causal explanation domains, was developed. The IAT presented 22 stimuli (words and pictures) to be categorized into the four categories. After 360 university students completed the IAT, a Many-Facet Rasch Measurement (MFRM) modelling approach was applied. The model specified a person latency parameter and a stimulus latency parameter. Two additional parameters were introduced to denote the order of presentation of the task associative conditions and the general response accuracy. Beyond the overall definition of the latent measurement dimension, the MFRM was also applied to disentangle the effect of the task block order and the general response accuracy on the stimuli response latency. Further, the MFRM allowed detecting any differential functioning of each stimulus in relation to both block ordering and accuracy. The results evidenced: a) the existence of a latency measurement dimension underlying the Mental Illness versus Physical Illness - Implicit Association Test; b) significant effects of block order and accuracy on the overall latency; c) a differential functioning of specific stimuli. The results of the present study can contribute to a better understanding of the functioning of an implicit measure of semantic associations with mental illness and give a first blueprint for the examination of relevant issues in the development of an IAT. PMID:25000406

An implicit measure of associations with mental illness versus physical illness: response latency decomposition and stimuli differential functioning in relation to IAT order of associative conditions and accuracy.

PubMed

Mannarini, Stefania; Boffo, Marilisa

2014-01-01

The present study aimed at the definition of a latent measurement dimension underlying an implicit measure of automatic associations between the concept of mental illness and the psychosocial and biogenetic causal explanatory attributes. To this end, an Implicit Association Test (IAT) assessing the association between the Mental Illness and Physical Illness target categories to the Psychological and Biologic attribute categories, representative of the causal explanation domains, was developed. The IAT presented 22 stimuli (words and pictures) to be categorized into the four categories. After 360 university students completed the IAT, a Many-Facet Rasch Measurement (MFRM) modelling approach was applied. The model specified a person latency parameter and a stimulus latency parameter. Two additional parameters were introduced to denote the order of presentation of the task associative conditions and the general response accuracy. Beyond the overall definition of the latent measurement dimension, the MFRM was also applied to disentangle the effect of the task block order and the general response accuracy on the stimuli response latency. Further, the MFRM allowed detecting any differential functioning of each stimulus in relation to both block ordering and accuracy. The results evidenced: a) the existence of a latency measurement dimension underlying the Mental Illness versus Physical Illness - Implicit Association Test; b) significant effects of block order and accuracy on the overall latency; c) a differential functioning of specific stimuli. The results of the present study can contribute to a better understanding of the functioning of an implicit measure of semantic associations with mental illness and give a first blueprint for the examination of relevant issues in the development of an IAT.

Quality of life in mentally ill, physically ill and healthy individuals: the validation of the Greek version of the World Health Organization Quality of Life (WHOQOL-100) questionnaire.

PubMed

Ginieri-Coccossis, Maria; Triantafillou, Eugenia; Tomaras, Vlasis; Liappas, Ioannis A; Christodoulou, George N; Papadimitriou, George N

2009-10-13

The World Health Organization Quality of Life (WHOQOL-100) questionnaire is a generic quality of life (QoL) measurement tool used in various cultural and social settings and across different patient and healthy populations. The present study examines the psychometric properties of the Greek version, with an emphasis on the ability of the instrument to capture QoL differences between mentally ill, physically ill and healthy individuals. A total of 425 Caucasian participants were tested, as to form 3 groups: (a) 124 psychiatric patients (schizophrenia n = 87, alcohol abuse/dependence n = 37), (b) 234 patients with physical illness (hypertension n = 139, cancer n = 95), and (c) 67 healthy control individuals. Confirmatory factor analysis was performed indicating that a four-factor model can provide an adequate instrument structure for the participating groups (GFI 0.92). Additionally, internal consistency of the instrument was shown to be acceptable, with Cronbach's alpha values ranging from 0.78 to 0.90 regarding the four -domain model, and from 0.40 to 0.90 regarding the six-domain one. Evidence based on Pearson's r and Independent samples t-test indicated satisfactory test/retest reliability, as well as good convergent validity tested with the General Health Questionnaire (GHQ-28) and the Life Satisfaction Inventory (LSI). Furthermore, using Independent samples t-test and one-way ANOVA, the instrument demonstrated good discriminatory ability between healthy, mentally ill and physically ill participants, as well as within the distinct patient groups of schizophrenic, alcohol dependent, hypertensive and cancer patients. Healthy individuals reported significantly higher QoL, particularly in the physical health domain and in the overall QoL/health facet. Mentally ill participants were distinctively differentiated from physically ill in several domains, with the greatest difference and reduction observed in the social relationships domain and in the overall QoL/health facet. Within the four distinct patient groups, alcohol abuse/dependence patients were found to report the most seriously compromised QoL in most domains, while hypertensive and cancer patients did not report extensive and significant differences at the domain level. However, significant differences between patient groups were observed at the facet level. For example, regarding the physical domain, physically ill participants reported more compromised scores in the pain/discomfort facet, while mentally ill participants in the facets of energy/fatigue, daily living activities and dependence on medication. The findings of the study indicate that the Greek version of WHOQOL-100 provided satisfactory psychometric properties supporting its use within general and pathological populations and in the context of national and crosscultural QoL measurement.

Looking at the world through a frosted window: experiences of loneliness among persons with mental ill-health.

PubMed

Lindgren, B-M; Sundbaum, J; Eriksson, M; Graneheim, U H

2014-03-01

Mental ill-health is reported to be of major concern in public health. Persons suffering from mental ill-health are a vulnerable group, and loneliness influences the perception of physical, social, and emotional well-being. However, there are few studies exploring lived experiences of loneliness among people with mental ill-health. This qualitative study aimed to illuminate experiences of loneliness among people with mental ill-health. Five individual, informal conversational interviews were performed and subjected to qualitative content analysis. The main findings showed that experiences of loneliness could be metaphorically described as looking at the world through a frosted window. The experiences of loneliness were multifaceted and altering as well as emotionally and socially excluding. The findings are discussed in relation to Tillich dimensions of loneliness: loneliness as a painful dimension of being alone, and solitude as the enriching dimension of being alone. People suffering from mental ill-health carry a twofolded stigma. They feel socially undesirable because of their mental ill-health, and the social perceptions of lonely people are generally unfavourable. We believe that mental health nurses can support the developing and creative dimension of loneliness through a confirming approach, where people with mental ill-health feel seen, heard, and respected as human beings. © 2013 John Wiley & Sons Ltd.

What does mental health nursing contribute to improving the physical health of service users with severe mental illness? A thematic analysis.

PubMed

Gray, Richard; Brown, Eleanor

2017-02-01

Authors have generally reported that mental health nurses (MHNs) have positive attitudes to providing physical health care to service users with severe mental illness. In the present study, we aimed to explore if this positive attitude translates to enhanced clinical practice by interviewing MHNs and the service users they work with. Semistructured interviews were completed with 15 service users and 18 MHNs from acute, rehabilitation, and community services. These were then transcribed and analysed using thematic analysis. Six themes emerged: (i) not the work of MHNs; (ii) the physical effects of psychiatric drugs are ignored; (iii) the need to upskill; (iv) keeping busy; (v) horrible hospital food/living on takeaways; and (vi) motivation to change. Our overarching meta-theme was of unmet physical health need among service users. © 2016 Australian College of Mental Health Nurses Inc.

Are there associations among physical activity, fatigue, sleep quality and pain in people with mental illness? A pilot study.

PubMed

Connaughton, J; Patman, S; Pardoe, C

2014-10-01

Good mental health is imperative to well-being. Symptoms of fatigue, chronic pain and poor sleep are common in people with mental illness and contribute to substantial loss of functioning. Physical exercise interventions have shown to decrease these symptoms in a range of populations; however, their possible association with physical activity related to day-to-day functioning have not been explored in people hospitalized with severe mental illness. Inpatients (n = 4) of a metropolitan mental health facility were fitted with an Actiwatch, which collected physical activity and sleep measures for an anticipated 14-day data collection period. During this time, morning and evening pain and fatigue scores were collected on an 11-point numerical rating scale. Significant associations were found between morning pain and morning fatigue scores (β = -0.44, P = 0.023), morning pain and physical activity (β = 12.34, P = 0.042), and physical activity and evening pain scores (β = 0.20, P = 0.017). Fatigue tended towards interfering more with quality of life than did pain, but this was not significant (P = 0.07). This study provided preliminary data suggesting associations between pain and fatigue, and intensity of pain and physical activity levels. This information can be used to generate hypotheses for future clinical trials. © 2013 John Wiley & Sons Ltd.

The Association between Mental Health and Acute Infectious Illness among a National Sample of 18- To 24-Year-Old College Students

ERIC Educational Resources Information Center

Adams, Troy B.; Wharton, Christopher M.; Quilter, Lyndsay; Hirsch, Tiffany

2008-01-01

Poor mental health is associated with physical illness, but this association is poorly characterized among college students. Objective and Participants: Using American College Health Association-National College Health Assessment data, the authors characterized poor mental health (depression, anxiety, negative affect) and examined the relationship…

Care Giving of People with Severe Mental Illness: An Indian Experience

PubMed Central

Janardhana, Navaneetham; Raghunandan, Shravya; Naidu, Dodala Muniratnam; Saraswathi, L.; Seshan, Valli

2015-01-01

Background: Caring is a fundamental issue in the rehabilitation of a person with mental illness and more so for people with severe mental illness. The lack of adequate manpower resources in the country is adding and enlisting the responsibility of providing care on the families to provide physical, medical, social and psychological care for their severely unwell mentally ill people. Aim of the Study: To examine the load of caregiving with reference to the types of care during the symptomatic and remission phases of severe mental illness and the various ways in which caregivers adapt their lives to meet the needs of people with severe mental illness. Materials and Methods: The present research draws its data from the 200 families with mental illness in Andra Pradesh and Karnataka in India. The data presented in the study was collected from interviews using an interview schedule with open-ended questions. Results: The study diffuses the notion of ‘care’ as ‘physical’, ‘medical, ‘psychological’ and ‘social’ care. The present article focuses on the caregiving roles of the caregivers of people with schizophrenia, affective disorders and psychosis not otherwise specified (NOS) and found that the caregiving does not differ much between the different diagnosis, but caregiving roles changes from active involvement in physical and medical care to more of social and psychological care during the remission. Conclusion: The study records the incredulous gratitude of caregivers at being acknowledged for the work they do. In that regard, the study itself provides a boost to the morale of tired, unacknowledged caregivers. PMID:25969605

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

PubMed

Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and the comfort of their familiar living environment, veterans were assisted to meet their physical and mental health goals with a program that could easily be integrated into their daily lives. Healthy People 2020 developed goals to improve levels of physical activity and has ranked physical activity as a leading health indicator (US DHHS. Office of Disease Prevention and Health Promotion. Physical activity topic overview. In Healthy People 2020. 2016. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity). Individuals with SMI are significantly less active than the general population (Shor and Shalev, 2014). It is sometimes difficult for the average individual to obtain the recommended 10,000 steps and even more difficult for those with SMI. Lifestyle modifications, in particular diet and exercise, are recommended for improvement of chronic disease outcomes (US Preventive Services Counseling Task Force, 2016). The health benefits of physical activity for people with SMI are mixed (Pearsall R, Smith D, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: A systematic review and meta-analysis. BMC Psychiatr. 2014;14:117). Some studies found significant physical health benefits, while others did not. However, according to a review by Soundy et al., physical exercise is shown to not only have physical benefits but also psychosocial benefits. One of the barriers that hinder participation in physical activities is accessibility (Shor and Shalev, 2014). Integrating a more personalized supported, and in-home pedometer program into mental healthcare should ensure better access to interventions that could possibly reverse the causes of premature death. The program was offered to 69 veterans in the MHICM. Forty-nine agreed to start the program and 20 declined. Twenty-five clients actually started the program with 17 veterans completing it. Preimplementation data included collecting blood pressure and weight measures for all veterans in the MHICM program. Additionally, a focus group was held with case managers to obtain a group perspective on motivating veterans to participate in this program. Further, a teaching session was held to review pedometers use, the client video, the client booklet, methods for getting veterans started, and the progression of the walking intervention. The pedometer physical activity intervention continued for 2 months. At the end of the 2 months, aggregate de-identified data on number of steps, blood pressure, and weight were collected. At the end of the program, the data were reviewed, synthesized, and analyzed, being careful to account for potentially intervening conditions and other chronic illnesses. The postimplementation data revealed that the mean weight decreased by 9 lbs. The percentage of controlled blood pressure increased from 60 to 84, while the percentage of uncontrolled blood pressure decreased from 40 to 16. Implementation of a multiple component personalized exercise intervention program for veterans with SMI contributed to reduction in weight and blood pressure. © 2017 Wiley Periodicals, Inc.

Mental health literacy among secondary school students in North and Central Uganda: a qualitative study

PubMed Central

Okello, Elialilia S.; Abbo, Catherine; Muhwezi, Wilson W.; Akello, Grace; Ovuga, Emilio

2015-01-01

Objectives There has been limited effort to explore young people’s perceptions about mental illness in Uganda. For mental health programs targeting young people to succeed, it is important to incorporate their understanding of mental illness, their perceptions about causes of mental illness and their attitudes about mentally ill people. The objective of this study was to explore the mental health of young people in secondary schools in Northern and Central Uganda. Subjects and Methods This was a qualitative study where 24 focus group discussions (FGDs) were held with young people in secondary schools. Respondents aged 14-24 years were purposively selected from 4 secondary schools in the two regions. During the FGDs, young people’s perceptions and understanding of three areas listed below were explored: meaning of mental health/mental illness; causes of mental illness and attitudes toward mental illness. Data management and analysis was done with the help of Atlas.ti, a-qualitative-analysis software. Thematic analysis approach was employed. Results FGD participants used concepts like a sound and normal mind, right thinking, normal behavior and normal thoughts to define mental health. Mental illness on the other hand was defined as loss of sense of reality, malfunctioning of the brain, impaired thinking and bizarre behavior. Young people attributed mental illness to; substance abuse (Marijuana, alcohol), witnessing traumatic events (seeing ones your relatives being killed, or being forced to participate in killing-frequently mentioned by young people in Northern Uganda); witch craft, effect of physical illness e.g. HIV/epilepsy, thinking too much, accidents and genetic explanations. They had mixed opinions about interacting with mentally ill individuals. Unpredictability and dangerousness were known to be a recurrent theme among people with negative views about mentally ill. Nonetheless, some FGD participants believed that the level of interaction with mentally ill persons depended on familiarity with mental illness and the severity of the symptoms. Similarly, there were mixed opinions regarding mental illness and work. Three main clusters of responses emerged. These were: i) “mentally ill people should not work”; ii) “mentally ill people should work but..”; iii) “mentally ill people should work like everyone else”. Conclusions Findings point to key gaps in the knowledge and attitudes of young people that need to be targeted by young-people-focused-interventions for mental health. In order for such interventions to succeed, young people must be able to recognize and respond appropriately to signs of distress, reduced functioning, and other early signs of poor mental health. PMID:26113883

Challenges for Policy Makers and Organizational Leaders: Addressing Trends in Mental Health Inequalities

PubMed Central

Rentmeester, Christy A.

2013-01-01

We typically think of acutely and chronically mentally ill patients as those who belong in psychiatric hospitals and the latter category of patients belonging in “regular” hospitals, but the intersection of physical and mental illness draws attention to important challenges for policy makers and organizational leaders. This article illuminates some broad trends in the health status of people with mental illnesses, canvasses important features of inequalities suffered by people with mental illnesses, and suggests strategies for systemic reform. Most reform recommendations I offer are in the area of healthcare organization leadership and management. Other key reforms will likely be legislative, regulatory, and insurance-related. Social and cultural reforms in organizational practices and structures will also be critical. PMID:24596844

Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David; Hanley, Christine

2015-01-01

People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n=643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers.

Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis.

PubMed

Vancampfort, Davy; Firth, Joseph; Schuch, Felipe B; Rosenbaum, Simon; Mugisha, James; Hallgren, Mats; Probst, Michel; Ward, Philip B; Gaughran, Fiona; De Hert, Marc; Carvalho, André F; Stubbs, Brendon

2017-10-01

People with severe mental illness (schizophrenia, bipolar disorder or major depressive disorder) die up to 15 years prematurely due to chronic somatic comorbidities. Sedentary behavior and low physical activity are independent yet modifiable risk factors for cardiovascular disease and premature mortality in these people. A comprehensive meta-analysis exploring these risk factors is lacking in this vulnerable population. We conducted a meta-analysis investigating sedentary behavior and physical activity levels and their correlates in people with severe mental illness. Major electronic databases were searched from inception up to April 2017 for articles measuring sedentary behavior and/or physical activity with a self-report questionnaire or an objective measure (e.g., accelerometer). Random effects meta-analyses and meta-regression analyses were conducted. Sixty-nine studies were included (N=35,682; 39.5% male; mean age 43.0 years). People with severe mental illness spent on average 476.0 min per day (95% CI: 407.3-545.4) being sedentary during waking hours, and were significantly more sedentary than age- and gender-matched healthy controls (p=0.003). Their mean amount of moderate or vigorous physical activity was 38.4 min per day (95% CI: 32.0-44.8), being significantly lower than that of healthy controls (p=0.002 for moderate activity, p<0.001 for vigorous activity). People with severe mental illness were significantly less likely than matched healthy controls to meet physical activity guidelines (odds ratio = 1.5; 95% CI: 1.1-2.0, p<0.001, I 2 =95.8). Lower physical activity levels and non-compliance with physical activity guidelines were associated with male gender, being single, unemployment, fewer years of education, higher body mass index, longer illness duration, antidepressant and antipsychotic medication use, lower cardiorespiratory fitness and a diagnosis of schizophrenia. People with bipolar disorder were the most physically active, yet spent most time being sedentary. Geographical differences were detected, and inpatients were more active than outpatients and those living in the community. Given the established health benefits of physical activity and its low levels in people with severe mental illness, future interventions specifically targeting the prevention of physical inactivity and sedentary behavior are warranted in this population. © 2017 World Psychiatric Association.

Causal explanations for class inequality in health--an empirical analysis.

PubMed

Lundberg, O

1991-01-01

One of the most important issues for research on social class inequalities in health are the causes behind such differences. So far, the debate on class inequalities in health has mainly been centred around hypotheses on artefactual and selectional processes. Although most contributors to this branch of research have argued in favour of causal explanations, these have gained very little systematic scrutiny. In this article, several possible causal factors are singled out for empirical testing. The effect of these factors on class differences in physical and mental illness is studied by means of logit regressions. On the basis of these analyses, it is shown that physical working conditions are the prime source of class inequality in physical illness, although economic hardship during upbringing and health related behaviours also contribute. For class inequality in mental illness these three factors plus weak social network are important. In sum, a large part of the class differences in physical as well as mental illness can be understood as a result of systematic differences between classes in living conditions, primarily differences in working conditions.

Mental health nursing and physical health care: a cross-sectional study of nurses' attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness.

PubMed

Robson, Debbie; Haddad, Mark; Gray, Richard; Gournay, Kevin

2013-10-01

Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however, there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical health care and explore associations with their practice and training. A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n = 585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice regarding cancer screening and smoking cessation. Having received post-registration physical health-care training and working in inpatient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post-registration physical health training or had an additional adult/general nursing qualification. Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognized. However, there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.

PubMed

Calogero, Samantha; Caley, Charles F

To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Using the serious mental illness health improvement profile [HIP] to identify physical problems in a cohort of community patients: a pragmatic case series evaluation.

PubMed

Shuel, Francis; White, Jacquie; Jones, Martin; Gray, Richard

2010-02-01

The physical health of people with serious mental illness is a cause of growing concern to clinicians. Life expectancy in this population may be reduced by up to 25 years and patients often live with considerable physical morbidity that can dramatically reduce quality of life and contribute to social exclusion. This study sought to determine whether the serious mental illness health improvement profile [HIP], facilitated by mental health nurses [MHNs], has the clinical potential to identify physical morbidity and inform future evidence-based care. Retrospective documentation audit and qualitative evaluation of patients' and clinicians' views about the use of the HIP in practice. A nurse-led outpatient medication management clinic, for community adult patients with serious mental illness in Scotland. 31 Community patients with serious mental illness seen in the clinic by 2 MHNs trained to use the HIP. All 31 patients, 9 MHNs, 4 consultant psychiatrists and 12 general practitioners [GPs] (primary care physicians) participated in the qualitative evaluation. A retrospective documentation audit of case notes for all patients where the HIP had been implemented. Semi-structured interviews with patients and their secondary care clinicians. Postal survey of GPs. 189 Physical health issues were identified (mean 6.1 per patient). Items most frequently flagged 'red', suggesting that intervention was required, were body mass index [BMI] (n=24), breast self-examination (n=23), waist circumference (n=21), pulse (n=14) and diet (n=13). Some rates of physical health problems observed were broadly similar to those reported in studies of patients receiving antipsychotics in primary care but much lower than those reported in epidemiological studies. Individualised care was planned and delivered with each patient based on the profile. 28 discreet interventions that included providing advice, promoting health behavioural change, performing an electrocardiogram and making a referral to professional colleagues were used. Qualitative feedback was positive. Our observations support the use of the HIP in clinical settings to enhance mental health nursing practice; however, we strongly recommend that training is required to support the use of the HIP. Copyright 2009 Elsevier Ltd. All rights reserved.

Motor skills, cognition, and work performance of people with severe mental illness.

PubMed

Lipskaya-Velikovsky, Lena; Elgerisi, Dikla; Easterbrook, Adam; Ratzon, Navah Z

2018-01-12

Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.

Wearable Devices and Mobile Technologies for Supporting Behavioral Weight Loss Among People with Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Scherer, Emily A.; McHugo, Gregory J.; Marsch, Lisa A.; Bartels, Stephen J.

2016-01-01

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. PMID:27479104

Enrollment of Specialty Mental Health Clinics in a State Medicaid Program to Promote Physical Health Services

PubMed Central

Breslau, Joshua; Yu, Hao; Horvitz-Lennon, Marcela; Leckman-Westin, Emily; Scharf, Deborah M.; Connor, Kathryn; Finnerty, Molly T.

2016-01-01

OBJECTIVE To promote integrated physical health care for individuals with serious mental illness, the New York State Office of Mental Health (NYOMH) established regulations allowing specialty mental health clinics to provide Medicaid-reimbursable health monitoring (HM) and health physicals (HP). This paper examines clinics’ enrollment in this program to understand its potential to reach individuals with serious mental illness. METHODS Information on enrollment and clinic characteristics (N=500) were drawn from NYOMH administrative databases. Clinic enrollment in the HM/HP program was examined from the program’s first five years (2010–2015). Logistic regression models accounting for the clustering of multiple clinics within agencies were used to examine characteristics associated with enrollment. RESULTS Two-hundred ninety one of 500 clinics (58%) enrolled in the HM/HP program, potentially reaching 62.5% of all Medicaid enrollees with serious mental illness seen in specialty mental health clinics in the state. State-operated clinics were required to participate, and had 91.8% enrollment. Over half of hospital-affiliated and freestanding mental health clinics elected to enroll in the program (52.6% and 53.7% respectively). In adjusted models, enrollment was higher among freestanding clinics relative to hospital-affiliated clinics, higher in larger relative to smaller clinics, and higher in county-operated relative to private non-profit clinics. CONCLUSIONS The high level of enrollment in the HM/HP program indicates strong interest among mental health clinics in providing physical health care services. However, supplemental policies may be needed to extend the program to areas of the mental health system where barriers to physical health care services are highest. PMID:27524372

Physical health care monitoring for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-01-17

Current guidance suggests that we should monitor the physical health of people with serious mental illness, and there has been a significant financial investment over recent years to provide this. To assess the effectiveness of physical health monitoring, compared with standard care for people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (October 2009, update in October 2012), which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised clinical trials focusing on physical health monitoring versus standard care, or comparing i) self monitoring versus monitoring by a healthcare professional; ii) simple versus complex monitoring; iii) specific versus non-specific checks; iv) once only versus regular checks; or v) different guidance materials. Initially, review authors (GT, AC, SM) independently screened the search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. Forty-two additional citations were identified in October 2012 and screened by two review authors (JX and MW), 11 of which underwent full screening. No relevant randomised trials which assess the effectiveness of physical health monitoring in people with serious mental illness have been completed. We identified one ongoing study. There is still no evidence from randomised trials to support or refute current guidance and practice. Guidance and practice are based on expert consensus, clinical experience and good intentions rather than high quality evidence.

Stigmatization of mental illness among Nigerian schoolchildren.

PubMed

Ronzoni, Pablo; Dogra, Nisha; Omigbodun, Olayinka; Bella, Tolulope; Atitola, Olayinka

2010-09-01

Despite the fact that about 10% of children experience mental health problems, they tend to hold negative views about mental illness. The objective of this study was to investigate the views of Nigerian schoolchildren towards individuals with mental illness or mental health problems. A cross-sectional design was used. Junior and senior secondary schoolchildren from rural and urban southwest Nigeria were asked: 'What sorts of words or phrases might you use to describe someone who experiences mental health problems?' The responses were tabulated, grouped and interpreted by qualitative thematic analysis. Of 164 students, 132 (80.5%) responded to the question. Six major themes emerged from the answers. The most popular descriptions were 'derogatory terms' (33%). This was followed by 'abnormal appearance and behaviour' (29.6%); 'don't know' answers (13.6%); 'physical illness and disability' (13.6%); 'negative emotional states' (6.8%); and 'language and communication difficulties' (3.4%). The results suggest that, similar to findings elsewhere, stigmatization of mental illness is highly prevalent among Nigerian children. This may be underpinned by lack of knowledge regarding mental health problems and/or fuelled by the media. Educational interventions and encouraging contact with mentally ill persons could play a role in reducing stigma among schoolchildren.

Attitudes Toward Euthanasia for Patients Who Suffer From Physical or Mental Illness.

PubMed

Levin, Kfir; Bradley, Graham L; Duffy, Amanda

2018-01-01

This study examined whether attitudes toward euthanasia vary with type of illness and with the source of the desire to end the patient's life. The study used a 3 (illness type: cancer, schizophrenia, depression) × 2 (euthanasia type: patient-initiated, family-initiated) between-groups experimental design. An online questionnaire was administered to 324 employees and students from a Australian public university following random assignment of participants to one of the six vignette-based conditions. Attitudes toward euthanasia were more positive for patients with a physical illness than a mental illness. For a patient with cancer or depression, but not schizophrenia, approval was greater for patient-, than, family-, initiated euthanasia. Relationships between illness type and attitudes were mediated by perceptions of patient autonomy and illness controllability. Findings have implications for debate, practices, and legislation regarding euthanasia.

Construct Validity of the SF-12v2 for the Homeless Population with Mental Illness: An Instrument to Measure Self-Reported Mental and Physical Health

PubMed Central

Chum, Antony; Skosireva, Anna; Tobon, Juliana; Hwang, Stephen

2016-01-01

Background Self-reported health measures are important indicators used by clinicians and researchers for the evaluation of health interventions, outcome assessment of clinical studies, and identification of health needs to improve resource allocation. However, the application of self-reported health measures relies on developing reliable and valid instruments that are suitable across diverse populations. The main objective of this study is to evaluate the construct validity of the SF-12v.2, an instrument for measuring self-rated physical and mental health, for homeless adults with mental illness. Various interventions have been aimed at improving the health of homeless people with mental illness, and the development of valid instruments to evaluate these interventions is imperative. Study Design We measured self-rated mental and physical health from a quota sample of 575 homeless people with mental illness using the SF-12v2, EQ-5D, Colorado Symptoms Index, and physical/mental health visual analogue scales. We examined the construct validity of the SF-12v2 through confirmatory factor analyses (CFA), and using ANOVA/correlation analyses to compare the SF-12v2 to the other instruments to ascertain discriminant/convergent validity. Results Our CFA showed that the measurement properties of the original SF-12v2 model had a mediocre fit with our empirical data (χ2 = 193.6, df = 43, p < .0001, CFI = 0.85, NFI = 0.83, RMSEA = 0.08). We demonstrate that changes based on theoretical rationale and previous studies can significantly improve the model, achieving an excellent fit in our final model (χ2 = 160.6, df = 48, p < .0001, CFI = 0.95, NFI = 0.95, RMSEA = 0.06). Our CFA results suggest that an alternative scoring method based on the new model may optimize health status measurement of a homeless population. Despite these issues, convergent and discriminant validity of the SF-12v2 (scored based on the original model) was supported through multiple comparisons with other instruments. Conclusion Our study demonstrates for the first time that the SF-12v2 is generally appropriate as a measure of physical and mental health status for a homeless population with mental illness. PMID:26938990

Construct Validity of the SF-12v2 for the Homeless Population with Mental Illness: An Instrument to Measure Self-Reported Mental and Physical Health.

PubMed

Chum, Antony; Skosireva, Anna; Tobon, Juliana; Hwang, Stephen

2016-01-01

Self-reported health measures are important indicators used by clinicians and researchers for the evaluation of health interventions, outcome assessment of clinical studies, and identification of health needs to improve resource allocation. However, the application of self-reported health measures relies on developing reliable and valid instruments that are suitable across diverse populations. The main objective of this study is to evaluate the construct validity of the SF-12v.2, an instrument for measuring self-rated physical and mental health, for homeless adults with mental illness. Various interventions have been aimed at improving the health of homeless people with mental illness, and the development of valid instruments to evaluate these interventions is imperative. We measured self-rated mental and physical health from a quota sample of 575 homeless people with mental illness using the SF-12v2, EQ-5D, Colorado Symptoms Index, and physical/mental health visual analogue scales. We examined the construct validity of the SF-12v2 through confirmatory factor analyses (CFA), and using ANOVA/correlation analyses to compare the SF-12v2 to the other instruments to ascertain discriminant/convergent validity. Our CFA showed that the measurement properties of the original SF-12v2 model had a mediocre fit with our empirical data (χ2 = 193.6, df = 43, p < .0001, CFI = 0.85, NFI = 0.83, RMSEA = 0.08). We demonstrate that changes based on theoretical rationale and previous studies can significantly improve the model, achieving an excellent fit in our final model (χ2 = 160.6, df = 48, p < .0001, CFI = 0.95, NFI = 0.95, RMSEA = 0.06). Our CFA results suggest that an alternative scoring method based on the new model may optimize health status measurement of a homeless population. Despite these issues, convergent and discriminant validity of the SF-12v2 (scored based on the original model) was supported through multiple comparisons with other instruments. Our study demonstrates for the first time that the SF-12v2 is generally appropriate as a measure of physical and mental health status for a homeless population with mental illness.

42 CFR 483.45 - Specialized rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... If specialized rehabilitative services such as but not limited to physical therapy, speech-language pathology, occupational therapy, and mental health rehabilitative services for mental illness and mental...

Islamic Values and Mental Health.

ERIC Educational Resources Information Center

Nassir, Balkis

Mental well-being is as important as physical well-being for sound life of man, and perhaps even more important, since physical illnesses are related in varying degrees to psychological problems. Modern psychology emphasizes essential criteria for mental health and well-being. These include positive relationships with others, productivity and…

Perceptions of Biopsychosocial Services Needs among Older Adults with Severe Mental Illness: Met and Unmet Needs

ERIC Educational Resources Information Center

Cummings, Sherry M.; Cassie, Kimberly McClure

2008-01-01

This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health center to participate in the…

Physics of Fission and Fusion for the Diagnostics and Monitoring of the Deadliest Illness of Mankind

NASA Astrophysics Data System (ADS)

Saxena, Arjun

2015-03-01

The physics of fission and fusion has been well known for the past several decades. It has been used primarily for destructive purposes (e. g., nuclear armaments) with both processes. However for peaceful purposes, e. g., generation of energy, only fission has been used, but not yet fusion. It is also well known that the deadliest illness of mankind is the group of illnesses called mental illnesses. A large segment of the world population is afflicted by them causing more loss of human lives, destruction of families, businesses and overall economy than all the other illnesses combined. Despite outstanding advancements in medical research and huge investments, unfortunately no diagnostic techniques have yet been found which can characterize the patient's mental illness. Consequently, no quantitative monitoring techniques are available to evaluate the efficacy of the various medicines used to treat the patients, and to develop them in the pharmaceutical labs. The purpose of this paper is to apply the constructive aspects of fission and fusion to identify the missing links in the diagnosis and treatment of mental illnesses. Each patient is a unique human being, not a disease or a group of symptoms. This makes it even more difficult to treat the patients suffering from mental illnes

Health-related quality of life in college students with and without childhood-onset asthma.

PubMed

Fedele, D A; Mullins, L L; Eddington, A R; Ryan, J L; Junghans, A N; Hullmann, S E

2009-10-01

The current study investigated whether differences existed in health-related quality of life between individuals who self-identified as having childhood-onset asthma and individuals without a chronic illness. Additionally, the relationship between perceived illness intrusiveness and illness uncertainty to health-related quality of life was explored. College undergraduates at least 18 years of age who self-identified as having childhood asthma were randomly matched by age and gender to healthy control participants. Participants completed a demographic form, the Mishel Uncertainty in Illness Scale-Community Form, the Illness Intrusiveness Scale, and the SF-36 Health Survey, a measure of health-related quality of life. Participants with asthma had significantly lower scores on the total and mental health-related quality of life scales than did healthy control subjects. There were no significant differences between self-identified participants with asthma and matched healthy control subjects on physical health-related quality of life scales. Illness intrusiveness was not related to either the physical (e.g., physical functioning, general health) or mental health-related quality of life. Higher levels of illness uncertainty were significantly related to higher levels of mental health-related quality of life (e.g., vitality, mental health). In addition, participants with asthma scored significantly lower than healthy controls on the social functioning and role-emotional subscales. The current study adds to the extant literature by examining the relationships between illness intrusiveness, illness uncertainty, and health-related quality of life among a young adult population. College students with asthma appear to be at risk for diminished quality of life compared to a healthy comparison group. Further examination of various domains of health-related quality of life among older adolescents and young adults with childhood asthma is needed.

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness.

PubMed

Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda

2018-04-01

Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Childhood Risk Factors in Dually Diagnosed Homeless Adults.

ERIC Educational Resources Information Center

Blankertz, Laura E.; And Others

1993-01-01

Examined prevalence of five childhood risk factors (sexual abuse, physical abuse, parental mental illness, substance abuse, out-of-home placement) among dually diagnosed (mentally ill and substance abusing) homeless adults (n=156) in rehabilitation programs. Findings suggest that childhood risk factors, whether single or multiple, are very…

Individuals with Mental Illness Can Control Their Aggressive Behavior through Mindfulness Training

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Adkins, Angela D.; Wahler, Robert G.; Sabaawi, Mohamed; Singh, Judy

2007-01-01

Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a…

Kimberley Indigenous mental health: An examination of metabolic syndrome risk factors.

PubMed

Stanley, Susanne H; Laugharne, Jonathan D E; Chapman, Murray; Balaratnasingam, Sivasankaran

2016-10-01

There is an increased risk of physical health comorbidities in people with a mental illness. This paper examines the metabolic syndrome parameters for the general population, indigenous Australians and people with a mental illness, and compares them to a sample of predominantly indigenous adults with mental health problems. A longitudinal (24 month) audit of patient medical records was conducted between February 2011 and March 2013. The Kimberley Mental Health and Drug Service in Broome, Western Australia. Largely indigenous adults with a mental illness. Sample numbers increased from 56 at baseline (80% indigenous) to 136 at 18 months (70% indigenous). Waist circumference, blood pressure, fasting lipids, and fasting blood glucose. Preliminary assessment of the data indicates a high percentage of abnormalities at baseline and at the 18 month period on all four parameters, yet not all patients were assessed on a regular basis. Abnormalities in metabolic profiles consistent with the non-Indigenous mental health population were found. There are considerable challenges to implementing regular monitoring of physical and metabolic profiles of indigenous people in rural and remote communities. © 2015 National Rural Health Alliance Inc.

Self-Regulatory Fatigue: A Missing Link in Understanding Fibromyalgia and Other Chronic MultiSymptom Illnesses.

PubMed

Nes, Lise Solberg; Ehlers, Shawna L; Whipple, Mary O; Vincent, Ann

2017-04-01

Patients with chronic multisymptom illnesses such as fibromyalgia syndrome (FMS) are experiencing a multitude of physical and mental challenges. Facing such challenges may drain capacity to self-regulate, and research suggests patients with these illnesses may experience self-regulatory fatigue (SRF). This study sought to examine whether SRF can be associated with quality of life (QoL) in patients with FMS. Patients (N = 258) diagnosed with FMS completed self-report measures related to demographics, SRF (Self-Regulatory Fatigue 18 [SRF-18]), anxiety (Generalized Anxiety Disorder questionnaire [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), physical fatigue (Multidimensional Fatigue Inventory [MFI]), symptoms related to FMS (Fibromyalgia Impact Questionnaire [FIQ]), and QoL (36-Item Short-Form Health Survey [SF-36]). Hierarchical regressions showed higher SRF to be associated with lower QoL in terms of lower overall physical QoL, with subscales related to physical functioning, role limitations-physical, bodily pain, and general health (all P's > 0.001), as well as lower overall mental QoL, with subscales related to vitality, social functioning, role limitations-emotional, and mental health (all P's > 0.001). Including traditional predictors such as anxiety, depression, physical fatigue, and FMS-related symptoms as covariates in the analyses reduced the link between SRF and QoL somewhat, but the associations remained generally strong, particularly for SRF and mental QoL. This is the first study to show higher SRF relating to lower QoL for patients with FMS. Results suggest that SRF is distinct from anxiety, depression, and fatigue, and predicts QoL above and beyond these traditional factors in the area of chronic multisymptom illnesses such as FMS. SRF may be a "missing link" in understanding the complex nature of chronic multisymptom illnesses. © 2016 World Institute of Pain.

Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.

PubMed

Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B

2013-01-01

Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

Physical activity interventions for people with mental illness: a systematic review and meta-analysis.

PubMed

Rosenbaum, Simon; Tiedemann, Anne; Sherrington, Catherine; Curtis, Jackie; Ward, Philip B

2014-09-01

To determine effects of physical activity on depressive symptoms (primary objective), symptoms of schizophrenia, anthropometric measures, aerobic capacity, and quality of life (secondary objectives) in people with mental illness and explore between-study heterogeneity. MEDLINE, Cochrane Controlled Trials Register, PsycINFO, CINAHL, Embase, and the Physiotherapy Evidence Database (PEDro) were searched from earliest record to 2013. Randomized controlled trials of adults with a DSM-IV-TR, ICD-10, or clinician-confirmed diagnosis of a mental illness other than dysthymia or eating disorders were selected. Interventions included exercise programs, exercise counseling, lifestyle interventions, tai chi, or physical yoga. Study methodological quality and intervention compliance with American College of Sports Medicine (ACSM) guidelines were also assessed. Two investigators extracted data. Data were pooled using random-effects meta-analysis. Meta-regression was used to examine sources of between-study heterogeneity. Thirty-nine eligible trials were identified. The primary meta-analysis found a large effect of physical activity on depressive symptoms (n = 20; standardized mean difference (SMD) = 0.80). The effect size in trial interventions that met ACSM guidelines for aerobic exercise did not differ significantly from those that did not meet these guidelines. The effect for trials with higher methodological quality was smaller than that observed for trials with lower methodological quality (SMD = 0.39 vs 1.35); however, the difference was not statistically significant. A large effect was found for schizophrenia symptoms (SMD = 1.0), a small effect was found for anthropometry (SMD = 0.24), and moderate effects were found for aerobic capacity (SMD = 0.63) and quality of life (SMD = 0.64). Physical activity reduced depressive symptoms in people with mental illness. Larger effects were seen in studies of poorer methodological quality. Physical activity reduced symptoms of schizophrenia and improved anthropometric measures, aerobic capacity, and quality of life among people with mental illness. PROSPERO registration #CRD42012002012. © Copyright 2014 Physicians Postgraduate Press, Inc.

Improving the physical health of people with severe mental illness: boundaries of care provision.

PubMed

Ehrlich, Carolyn; Kendall, Elizabeth; Frey, Nicolette; Kisely, Steve; Crowe, Elizabeth; Crompton, David

2014-06-01

There is compelling evidence that the physical health of people with severe mental illness is poor. Health-promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence-based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Queensland, Australia. Fifty participants were interviewed. The core theme that emerged from the data was that of 'care boundaries' that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health-care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health-promotion practice. Thus, the implementation of evidence-based guidelines depended heavily on the capability of the workforce to develop and adopt boundary-mediating strategies. © 2013 Australian College of Mental Health Nurses Inc.

Comorbidities and psychotic illness. Part 1: Philosophy and clinical consequences.

PubMed

Agius, Mark; Aquilina, Francesca Falzon

2014-11-01

This article aims at addressing the implications of defining 'comorbidity' within the field of psychiatry. We have looked at the standard definition of comorbidity and then discussed whether this definition can be applied to comorbidities in psychiatry. While comorbidities in physical illness are clearly the coexistence of two independent illnesses, Comorbidities in Mental illness are the result of the polygenic nature of mental illnesses, especially in psychotic illness whether schizophrenia or bipolar disorder. As a consequence, often the comorbidities of psychiatric illness are caused by two conditions which have in common the presence of particular single nucleotide polymorphisms (snps), which regulate the metabolism of neurotransmitters or the presence of neurotrophic factors . Thus inevitably, many such comorbidities are inextricably linked. We discuss the consequences of this form of comorbidity for the description, classification, and risk profile of mental illness.

Physical activity and quality of life in long-term hospitalized patients with severe mental illness: a cross-sectional study.

PubMed

Deenik, Jeroen; Kruisdijk, Frank; Tenback, Diederik; Braakman-Jansen, Annemarie; Taal, Erik; Hopman-Rock, Marijke; Beekman, Aartjan; Tak, Erwin; Hendriksen, Ingrid; van Harten, Peter

2017-08-18

Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term hospitalized patients with severe mental illness and knowledge of the determinants of behavioural change is lacking. The purpose of this study was to elucidate the relationship between objectively measured physical activity and quality of life, and explore modifiable psychological determinants of change in physical activity in long-term hospitalized patients with severe mental illness. In 184 inpatients, physical activity was measured using an accelerometer (ActiGraph GTX+). Quality of life was assessed by EuroQol-5D and WHOQol-Bref. Attitude and perceived self-efficacy towards physical activity were collected using the Physical Activity Enjoyment Scale and the Multidimensional Self Efficacy Questionnaire, respectively. Patient and disease characteristics were derived retrospectively from electronic patient records. Associations and potential predictors were analysed using hierarchical regression. Physical activity was positively related with and a predictor of all quality of life outcomes except on the environmental domain, independent of patient and disease characteristics. However, non-linear relationships showed that most improvement in quality of life lies in the change from sedentary to light activity. Attitude and self-efficacy were not related to physical activity. Physical activity is positively associated with quality of life, especially for patients in the lower spectrum of physical activity. An association between attitude and self-efficacy and physical activity was absent. Therefore, results suggest the need of alternative, more integrated and (peer-)supported interventions to structurally improve physical activity in this inpatient population. Slight changes from sedentary behaviour to physical activity may be enough to improve quality of life.

Wearable Devices and Smartphones for Activity Tracking Among People with Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Bartels, Stephen J.

2016-01-01

Introduction People with serious mental illness, including schizophrenia spectrum and mood disorders, are more physically inactive than people from the general population. Emerging wearable devices and smartphone applications afford opportunities for promoting physical activity in this group. This exploratory mixed methods study obtained feedback from participants with serious mental illness to assess the acceptability of using wearable devices and smartphones to support a lifestyle intervention targeting weight loss. Methods Participants with serious mental illness and obesity enrolled in a 6-month lifestyle intervention were given Fitbit activity tracking devices and smartphones to use for the study. Participants completed quantitative post-intervention usability and satisfaction surveys, and provided qualitative feedback regarding acceptability of using these devices and recommendations for improvement through in-depth interviews. Results Eleven participants wore Fitbits for an average of 84.7% (SD=18.1%) of the days enrolled in the study (median=93.8% of the days enrolled, interquartile range=83.6–94.3%). Participants were highly satisfied, stating that the devices encouraged them to be more physically active and were useful for self-monitoring physical activity and reaching daily step goals. Some participants experienced challenges using the companion mobile application on the smartphone, and recommended greater technical support, more detailed training, and group tutorials prior to using the devices. Discussion Participants’ perspectives highlight the feasibility and acceptability of using commercially available mHealth technologies to support health promotion efforts targeting people with serious mental illness. This study offers valuable insights for informing future research to assess the effectiveness of these devices for improving health outcomes in this high-risk group. PMID:27134654

Comparing Personal Health Practices: Individuals with mental illness and the general Canadian population.

PubMed

Schofield, Ruth; Forchui, Cheryl; Montgomery, Phyllis; Rudnic, Abraham; Edwards, Betty; Meier, Amanda; Speechley, Mark

2016-06-01

Individuals with mental illness often live in chronic poverty, which is associated with personal health practices such as tobacco use and poor nutrition that disrupt physical health. The purpose of our study was to examine whether differences exist in personal health and health practices - related to nutrition, physical activity, smoking, alcohol consumption and sleep - between a cohort of individuals with mental illness in southwestern Ontario and the general Canadian population. The study sample consisted of 250 individuals who had had a psychiatric diagnosis for at least one year. We conducted a structured quantitative interview with each person to gather information about their personal health and health practices, using question wording from the National Population Health Survey and the Canadian Community Health Survey. We calculated 95% confidence intervals for our results and used them to compare our data with Canadian norms. Individuals with mental illness are significantly more likely than the general population to have a poor diet, experience poor sleep and consume alcohol in excess. It is important for nurses, health-care organizations and policy-makers to be aware that a number of factors may be influencing the personal health and health practices of individuals with mental illness and that this population may require different health promotion strategies to support a healthy lifestyle.

Wearable devices and mobile technologies for supporting behavioral weight loss among people with serious mental illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; McHugo, Gregory J; Marsch, Lisa A; Bartels, Stephen J

2016-10-30

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accelerometer-measured sedentary behaviour and physical activity of inpatients with severe mental illness.

PubMed

Kruisdijk, Frank; Deenik, Jeroen; Tenback, Diederik; Tak, Erwin; Beekman, Aart-Jan; van Harten, Peter; Hopman-Rock, Marijke; Hendriksen, Ingrid

2017-08-01

Sedentary behaviour and lack of physical activity threatens health. Research concerning these behaviours of inpatients with severe mental illness is limited but urgently needed to reveal prevalence and magnitude. In total, 184 inpatients (men n =108, women n =76, mean age 57,4, 20% first generation antipsychotics, 40% second generation antipsychotics, 43% antidepressants, mean years hospitalisation 13 years), with severe mental illness of a Dutch psychiatric hospital wore an accelerometer for five days to objectively measure total activity counts per hour and percentages in sedentary behaviour, light intensity physical activity and moderate to vigorous physical activity. Accelerometer data were compared with data of 54 healthy ward employees. Patients showed significantly less activity counts per hour compared to employees (p=0.02), although the differences were small (d=0.32). Patients were sedentary during 84% of the wear time (50min/h), spend 10% in light intensity physical activity and 6% in moderate to vigorous physical activity. Age was the only significant predictor, predicting less total activity counts/h in higher ages. Decreasing sedentary behaviour and improving physical activity in this population should be a high priority in clinical practice. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Improving the health of mental health staff through exercise interventions: a systematic review.

PubMed

Fibbins, Hamish; Ward, Philip B; Watkins, Andrew; Curtis, Jackie; Rosenbaum, Simon

2018-04-01

Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.

29 CFR 18.902 - Self-authentication.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., estimates, and reports. In actions involving injury, illness, disease, death, disability, or physical or... injury, illness, disease, death, disability or physical or mental impairment, doctor, hospital... including a summary of experience as an expert witness in litigation, when including the basic facts, data...

29 CFR 18.902 - Self-authentication.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., estimates, and reports. In actions involving injury, illness, disease, death, disability, or physical or... injury, illness, disease, death, disability or physical or mental impairment, doctor, hospital... including a summary of experience as an expert witness in litigation, when including the basic facts, data...

29 CFR 18.902 - Self-authentication.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., estimates, and reports. In actions involving injury, illness, disease, death, disability, or physical or... injury, illness, disease, death, disability or physical or mental impairment, doctor, hospital... including a summary of experience as an expert witness in litigation, when including the basic facts, data...

29 CFR 18.902 - Self-authentication.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., estimates, and reports. In actions involving injury, illness, disease, death, disability, or physical or... injury, illness, disease, death, disability or physical or mental impairment, doctor, hospital... including a summary of experience as an expert witness in litigation, when including the basic facts, data...

29 CFR 18.902 - Self-authentication.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., estimates, and reports. In actions involving injury, illness, disease, death, disability, or physical or... injury, illness, disease, death, disability or physical or mental impairment, doctor, hospital... including a summary of experience as an expert witness in litigation, when including the basic facts, data...

Physical activity preferences, motivators, barriers and attitudes of adults with mental illness.

PubMed

Chapman, Justin J; Fraser, Sarah J; Brown, Wendy J; Burton, Nicola W

2016-10-01

Adults with mental illness may have specific attitudes toward physical activity (PA). To assess the PA attitudes of non-institutionalised adults with mental illness, and associations with psychological distress. Participants completed questionnaires on activity preferences (type, context and sources of support), motivators, barriers and attitudes toward personal training (PT). Relationships between responses and distress were assessed using logistic regressions. One-hundred forty-two participants completed the questionnaires. PA context preferences included activities done close to home, outdoors, with professional instruction, with people of the same ability, as part of a healthy lifestyle program and with a social component. The most commonly endorsed source of support was an exercise instructor. Most respondents had never received PT; however, PT had high acceptability. Common barriers included poor physical and mental health, and lack of money. Distress was positively associated with barriers of poor mental health, tiredness, disorganisation, exhaustion and being shy/embarrassed (p ≤ 0.001). Local outdoor walking groups that include social and healthy lifestyle components, and that are led by an exercise instructor who can provide support for overcoming barriers, may best meet PA interests of this group. PT could be an acceptable method for offering individualised support.

[Are the representations of the "madman", the "mentally ill person", the "depressive" and the opinions towards psychiatric hospitals homogeneous according to the populations of the investigated sites?].

PubMed

Quidu, F; Escaffre, J P

2010-01-01

The concept of policy management in psychiatry requires knowledge representations of the "mad", the "mentally ill" and "depressed" by the people. It is therefore to highlight the diversity of definitions that it attributes to individual psychiatric disorders, particularly by cultural norms typically associated with geographic locations. To do this, we successively study the forms of stigmatisations broadly, and then by site, and the causes of thereof. But this does not suffice for the design of any policy in this area must also take into account the attitudes and behaviours of the population vis-à-vis the existing psychiatric facilities globally and per site. The treatments were carried out using data from the socio-anthropological and epidemiological "Mental Health in the general population: images and realities" made by the French Collaborating Centre of WHO for research and training Mental Health (WHOCC, Lille, France) and the Directorate of Research, Studies, Evaluation and Statistics (DREES) with 40 000 people aged 18 and older in metropolitan France and in the departments of overseas between 1999 and 2003. The techniques used range from descriptive statistics to multivariate analysis (correspondence analysis and multiple ascending hierarchical classification). The images of the "madness", the "mentally ill" or the "depression" in the French population are disparate. Nevertheless, some characteristics are found with high frequency: the "depressive" is rather seen as an isolated person, the "mentally ill" as a mental defective with bizarre speech, while "crazy" would rather characterized by violence (delusions and violent towards others, beat his family, incest). The "mentally ill" is sometimes defined by these last criteria. These images are not influenced by knowledge of a relative suffering from mental illness or a psychiatric episode experienced by the interviewee. The causes of mental illness (the "madness" and "mentally ill"), two contradictory trends have expressed. Some believe it has a physical origin, and in that case the healing is difficult and care must be hospitable. Others believe it was originally a non-physical (social), and in this case, recovery is possible, and care must be ambulatory. People surveyed in some sites have homogeneous opinions in this regard: Berk, Thuir or Guéret, the first opinion is mainly expressed, whereas the opposite trend was observed in Villejuif, Niort, Lille, Poitiers, Paris15, Paris10. In contrast, for depression, the cause is, for almost the entire population, non-physical. Overall, 41% of French people support psychiatric hospitals, while 32% oppose, preferring ambulatory solutions. In fact, opinions differ so widely among survey sites. They are not influenced by the images of people surveyed vis-à-vis the "madness", the "mentally ill" or the "depression". The way of organizing psychiatric sectorization (taken care rather intra-hospital versus extra-hospital, number of agents, etc.) does not influence either the image of "mad", the "mentally ill" or "depression" in population, nor the opinions vis-à-vis psychiatric hospitals. We deduce that these images are generated by other factors, probably cultural factors. Copyright 2010 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

Intimate partner violence and mental ill health among global populations of Indigenous women: a systematic review.

PubMed

Chmielowska, Marta; Fuhr, Daniela C

2017-06-01

Intimate partner violence (IPV) has been recognised as a major obstacle to the achievement of gender equality and human development. Its adverse physical and mental health consequences have been reported to affect women of all ages and backgrounds. Although Indigenous women seem to experience higher rates of partner abuse than non-Indigenous women, mental health consequences of IPV among this population are not yet clearly established in the literature. This study systematically reviewed the global literature on mental health outcomes and risk factors for mental ill health among Indigenous women who experienced IPV. Primary quantitative and mixed methods studies that reported about mental health and IPV among Indigenous women (aged 14+) were included. 21 bibliographic databases were searched until January 2017. Quality of included studies was assessed through the Newcastle-Ottawa Scale. Findings are reported according to PRISMA-P 2015. 13 studies were identified. The majority of studies reported very high rates of IPV and high prevalence of mental disorders. The most frequently identified types of IPV were physical and/or sexual violence, verbal aggression, and emotional abuse. The strongest predictor of poor mental health was physical violence. The most commonly reported mental health outcomes were depression and posttraumatic stress disorder. Despite the small number of studies identified, the available evidence suggests that experiences of IPV and mental disorders among Indigenous women are linked and exacerbated by poverty, discrimination, and substance abuse. More research is needed to better understand distributions and presentations of IPV-related mental illness in this population.

Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults.

PubMed

Cimo, Adriana; Dewa, Carolyn S

2017-11-08

People with mental illnesses are more likely to experience diabetes-related complications that can reduce life expectancy by 10 to 15 years. Diabetes management and outcomes can be improved when lifestyle interventions addressing healthful eating habits and physical activity use content tailored to the learning needs of individuals or groups. Understanding the challenges that prevent adherence to diabetes recommendations can start to inform the design of tailored diabetes education care. The purpose of this pilot study was to explore the perspectives of clients with mental illnesses and type 2 diabetes with regard to challenges faced when engaging in diabetes self-care behaviours. Focus groups were held with 17 people who had type 2 diabetes and mental illnesses, including depressive disorder, bipolar disorder, anxiety disorder, schizophrenia and schizoaffective disorder. In the groups, participants were asked to share their experiences with diabetes self-care and access to diabetes-education services. Data were transcribed verbatim, assessed for quality and saturation and coded to identify relationships and meanings among identified themes. Participants identified many challenges and unmet needs that created multidimensional and interrelated barriers to care, ultimately resulting in poor diabetes self-care behaviours. Some challenges were psychological in nature and related to emotional states, lifestyles and food habits, perceptions of affordability, health literacy and value of health information. Other challenges included the physical states of health and social environments. Multidimensional diabetes education programs that consider psychological, physical and social challenges are needed to address the needs of people with mental illnesses. Copyright © 2017. Published by Elsevier Inc.

Co-occurrence of mental and physical illness in U.S. Latinos

PubMed Central

Feldman, Jonathan M.; Canino, Glorisa; Steinman, Kenneth; Alegría, Margarita

2009-01-01

Background This study describes the prevalence of comorbid physical and mental health problems in a national sample of U.S. Latinos. We examined the co-occurrence of anxiety and depression with prevalent physical chronic illnesses in a representative sample of Latinos with national origins from Mexico, Cuba, Puerto Rico, and other Latin American countries. Method We used data on 2,554 Latinos (75.5% response rate) ages 18 years and older from the National Latino and Asian American Study (NLAAS). The NLAAS was based on a stratified area probability sample design, and the sample came from the 50 states and Washington, DC. Survey questionnaires were delivered both in person and over the telephone in multiple languages, including Spanish and English. Psychiatric disorders were assessed using the World Mental Health Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI). Physical chronic illness was assessed by self-reported history. Results Puerto Ricans had the highest prevalence of meeting criteria for any comorbid psychiatric disorder (more than one disorder). Puerto Ricans had the highest prevalence (22%) of subject-reported asthma history, while Cubans had the highest prevalence (33%) of cardiovascular disease. After accounting for age, sex, household income, number of years in the U.S., immigrant status, and comorbid anxiety and depression, anxiety was associated with diabetes and cardiovascular disease, in the entire sample. Depression and comorbid anxiety and depression were associated with asthma but not with other physical diseases, in the entire sample. The relationship between chronic physical and mental illness was not confounded by immigration status or number of years in the U.S. Discussion Despite previous findings that link acculturation with both chronic physical and mental illness, this study does not find that number of years in the US nor nativity explain the prevalence of psychiatric-medical comorbidities. This study demonstrates the importance of considering psychiatric and medical comorbidity among specific ethnic groups, as different patterns emerge than when using aggregate ethnic measures. Research is needed on both the pathways and the mechanisms of comorbidity for the specific Latino groups. PMID:17013767

Shared decision making among parents of children with mental health conditions compared to children with chronic physical conditions.

PubMed

Butler, Ashley M; Elkins, Sara; Kowalkowski, Marc; Raphael, Jean L

2015-02-01

High quality care in pediatrics involves shared decision making (SDM) between families and providers. The extent to which children with common mental health disorders experience SDM is not well known. The objectives of this study were to examine how parent-reported SDM varies by child health (physical illness, mental health condition, and comorbid mental and physical conditions) and to examine whether medical home care attenuates any differences. We analyzed data on children (2-17 years) collected through the 2009/2010 National Survey of Children with Special Health Care Needs. The sample consisted of parents of children in one of three child health categories: (1) children with a chronic physical illness but no mental health condition; (2) children with a common mental health condition but no chronic physical condition; and (3) children with comorbid mental and chronic physical conditions. The primary dependent variable was parent-report of provider SDM. The primary independent variable was health condition category. Multivariate linear regression analyses were conducted. Multivariate analyses controlling for sociodemographic variables and parent-reported health condition impact indicated lower SDM among children with a common mental health condition-only (B = -0.40; p < 0.01) and children with comorbid conditions (B = -0.67; p < 0.01) compared to children with a physical condition-only. Differences in SDM for children with a common mental health condition-only were no longer significant in the model adjusting for medical home care. However, differences in SDM for children with comorbid conditions persisted after adjusting for medical home care. Increasing medical home care may help mitigate differences in SDM for children with mental health conditions-only. Other interventions may be needed to improve SDM among children with comorbid mental and physical conditions.

General physical health advice for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew; Bachner, Mick

2011-02-16

There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To assess the effects of general physical health advice as a means of reducing morbidity, mortality and improving or maintaining quality of life in people with serious mental illness. We searched the Cochrane Schizophrenia Group Trials Register (November 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. All randomised clinical trials focusing on general physical health advice. We extracted data independently. For binary outcomes we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% CI. We employed a random-effects model for analyses. For the comparison of physical healthcare advice versus standard care we identified five studies (total n = 884) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.00 CI -0.67 to 0.67) but another did (n = 407, 1 RCT, MD Quality of Life Medical Outcomes Scale - mental component 3.7 CI 1.7 to 5.6). There was no difference between groups for the outcome of death (n = 407, 1 RCT, RR 1.3 CI 0.3 to 6.0), for the outcome of uptake of ill-health prevention services, one study found percentages significantly greater in the advice group (n = 363, 1 RCT, MD 36.9 CI 33.1 to 40.7). Economic data were equivocal. Attrition was large (> 30%) but similar for both groups (n = 884, 5 RCTs, RR 1.18 CI 0.97 to 1.43). Comparisons of one type of physical healthcare advice with another were grossly underpowered and equivocal. General physical health could lead to people with serious mental illness accessing more health services which, in turn, could mean they see longer term benefits such as reduced mortality or morbidity. On the other hand it is possible clinicians are expending much effort, time and financial expenditure on giving ineffective advice. This is an important area for good research reporting outcome of interest to carers and people with serious illnesses as well as researchers and fundholders.

Extermination of the Jewish mentally-ill during the Nazi era--the "doubly cursed".

PubMed

Strous, Rael

2008-01-01

In Nazi Germany, physicians initiated a program of sterilization and euthanasia directed at the mentally-ill and physically disabled. Relatively little is known regarding the fate of the Jewish mentally-ill. Jewish mentally-ill were definitely included and targeted and were among the first who fell victim. They were systematically murdered following transfer as a specialized group, as well as killed in the general euthanasia program along with non-Jewish mentally ill. Their murder constituted an important link between euthanasia and the Final Solution. The targeting of the Jewish mentally-ill was comprised of four processes including public assistance withdrawal, hospital treatment limitations, sterilization and murder. Jewish "patients" became indiscriminate victims not only on the basis of psychiatric diagnosis, but also on the basis of race. The killing was efficiently coordinated with assembly in collection centers prior to being transferred to their deaths. The process included deceiving Jewish patients' family members and caregivers in order to extract financial support long after patients had been killed. Jewish patients were targeted since they were helpless and considered the embodiment of evil. Since nobody stood up for the Jews, the Nazis could treat the Jewish patients as they saw fit. Several differences existed between euthanasia of Jews and non-Jews, among which the Jewish mentally-ill were killed regardless of work ability, hospitalization length or illness severity. Furthermore, there was discrimination in the process leading up to killing (overcrowding, less food). For the Nazis, Jewish mentally-ill patients were unique among victims in that they embodied both "hazardous genes" and "racial toxins." For many years there has been silence relating to the fate of the Jewish mentally-ill. This deserves to be corrected.

Prevalence of psychiatric and physical morbidity in an urban geriatric population.

PubMed

Seby, K; Chaudhury, Suprakash; Chakraborty, Rudraprosad

2011-04-01

With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Cross-sectional, epidemiological study. All the consenting elderly persons in a municipal ward division (n=202) were enrolled after surveying a total adult population of 7239 people. A door to door survey was undertaken where the participants were interviewed and physically examined. General Health Questionnaire-12, Mini Mental State Examination, CAGE Questionnaire and Geriatric Depression Scale were used in the interview apart from consulting the available documents. Other family members were also interviewed to verify the information. Chi-square test with Yates correction. Psychiatric illnesses were detected in 26.7% while physical illnesses were present in 69.8% of the population surveyed. Predominant psychiatric diagnoses were depressive disorders, dementia, generalized anxiety disorder, alcohol dependence and bipolar disorder. The most common physical illness was visual impairment, followed by cardiovascular disease, rheumatic illnesses, pulmonary illnesses, hearing impairment, genitourinary diseases and neurological disorders. Presence of dementia was associated with increased age, single/widowed/separated status, nuclear family, economic dependence, low education, cardiovascular disorders, rheumatic disorders and neurological disorders. Depression was associated with female sex, single/widowed/separated status, staying in nuclear families, economic dependence on others and co-morbid physical illnesses, specifically cardiovascular disorders and visual impairment. This study presented a higher rate of dementia and old age depression. The interesting association with several sociodemographic factors as well as physical illnesses may have important implications for health planning.

An Overview of Links Between Obesity and Mental Health.

PubMed

Avila, Christian; Holloway, Alison C; Hahn, Margaret K; Morrison, Katherine M; Restivo, Maria; Anglin, Rebecca; Taylor, Valerie H

2015-09-01

The American Medical Association recently recognized obesity as both an illness and a leading cause of preventable death and chronic disease. This association is not only linked to physical health outcomes, however, as obesity has also been extensively associated with mental illness as well. Both obesity and severe mental illness decrease quality of life and are associated with an increase in disability, morbidity, and mortality, and when they occur together, these adverse health outcomes are magnified. Despite educational campaigns, increased awareness, and improved treatment options, the high prevalence of mental illness and comorbid obesity remains a serious problem. This review examines this overlap, highlighting clinical and biological factors that have been linked to this association in order to improve our understanding and help elucidate potential therapeutic avenues.

Words about body and soul: social representations relating to health and illness.

PubMed

Åsbring, Pia

2012-11-01

The purpose was to examine a sample of Stockholm residents' social representations of their physical and mental health and ill-health. Four open-ended questions were answered by 1240 people between 18-80 years. A thematic analysis revealed nine aspects of health: physical, lifestyle, psychological, social, recreational, work and study, treatment, other and multifactorial aspects. Some cross-cutting themes were described to have an impact on health: empowerment, health-conscious lifestyle, life balance and life perspective. A key result is the interdependence between physical and mental health that was described by the respondents.

Microaggressions experienced by persons with mental illnesses: An exploratory study.

PubMed

Gonzales, Lauren; Davidoff, Kristin C; Nadal, Kevin L; Yanos, Philip T

2015-09-01

Microaggressions are subtle verbal or behavioral communications of disparaging messages to people based upon membership in a socially marginalized group. Their negative impact has been demonstrated for racial/ethnic groups, gender, sexual orientation, and physical disability, but currently no research exists on microaggressions as experienced by persons with mental illnesses. Qualitative data were gathered from 4 focus groups with 2 samples: adult mental health consumers in an assertive community treatment program and college students with mental illness diagnoses. Focus group transcripts were then analyzed using an open coding approach (Strauss & Corbin, 1990) to identify hierarchical themes and categories. Five major themes were identified, including invalidation, assumption of inferiority, fear of mental illness, shaming of mental illness, and second class citizen. Perpetrators of microaggressions were most commonly identified as being close friends, family members, and authority figures. Importantly, participants reported experiencing more overt discrimination experiences than subtle microaggression experiences. Reported negative outcomes related to microaggression experiences included isolation, negative emotions, and treatment nonadherence. Reported consequences of microaggressions have important implications for mental health treatment, especially as perpetrators were reported to include treatment providers and were usually unaware of such negative social exchanges. Loss of social support reported by participants and the frequent occurrence of microaggressions within close relationships implies these experiences could contribute to internalization of stigmatizing attitudes toward mental illness. Directions for future research include an investigation of motivation and reasoning behind perpetration of microaggressions against persons with mental illnesses. (c) 2015 APA, all rights reserved).

Uncivilizing "Mental Illness": Contextualizing Diverse Mental States and Posthuman Emotional Ecologies within The Icarus Project.

PubMed

Fletcher, Erica Hua

2018-03-01

This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as "mental illness," take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its members within posthuman emotional ecologies in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that "uncivilizes" mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health.

The Family Challenge of Caring for the Chronically Mentally Ill: A Phenomenological Study.

PubMed

Shamsaei, Farshid; Cheraghi, Fatemeh; Esmaeilli, Ravanbakhsh

2015-09-01

Family caregiving for patients with chronic mental illness is influenced by various factors such as political, socioeconomic, and cultural contexts as well as related policies and health services. The purpose of this study was to explore the challenges with which the family caregivers of patients with chronic mental illness have to contend. The research design was qualitative with a phenomenological approach. The research population consisted of 16 long-term carers expressing interest in participating in the project. The carers were the family members of mentally ill relatives who collected their monthly medications at Farshchian Psychiatry Hospital in Hamadan in 2012. Purposive sampling was used to draw the sample. Data were collected by individual in-depth semi-structured interviews, which were tape-recorded and analyzed via Colaizzi's phenomenological method. Rigor was assessed regarding credibility, dependability, conformability, and transferability. Our findings highlighted 4 main themes, namely stress and emotional distress, need for education and information, socioeconomic effects and support, and physical strain. Families experience frustrations when providing support and care to their mentally ill relatives. They, therefore, need appropriate support and intervention by mental health services.

PTSD'S mediation of the relationships between trauma, depression, substance abuse, mental health, and physical health in individuals with severe mental illness: evaluating a comprehensive model.

PubMed

Subica, Andrew M; Claypoole, Keith H; Wylie, A Michael

2012-04-01

Following trauma exposure and PTSD, individuals with severe mental illness (SMI) frequently suffer a complex course of recovery complicated by reduced mental and physical health and increased substance abuse. The authors evaluated a theoretical PTSD-SMI model which theorizes that trauma, PTSD, depression, substance abuse, mental health, and physical health are interrelated and that PTSD mediates these relationships. Participants were ethnoracially diverse individuals diagnosed with SMI (N=175) who were assessed for trauma exposure, severity of PTSD and depression, substance abuse, and overall mental and physical health functioning. Pearson's correlations were utilized to examine the relationships between study domains. The mediating effects of PTSD were assessed using regression coefficients and the Sobel test for mediation. A majority of participants with SMI (89%) reported trauma exposure and 41% reported meeting diagnostic criteria for PTSD. On average, participants were exposed to over four types of traumatic events. Trauma, severity of PTSD and depression, substance abuse, and overall mental and physical health functioning were significantly interrelated. PTSD partially mediated the relationships between trauma and severity of depression and between trauma and overall mental health; PTSD fully mediated the trauma and overall physical health relationship. Within an ethnoracially diverse SMI sample, trauma exposure and PTSD comorbidity were high and associated with severity of depression, substance abuse, overall mental health and physical health functioning. Supporting our theoretical PTSD-SMI model, PTSD mediated the adverse effects of trauma exposure on participants' current severity of depression and overall mental and physical health functioning. Copyright © 2011 Elsevier B.V. All rights reserved.

Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

PubMed

Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve

2015-09-14

Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners. This research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.

Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach.

PubMed

Quirk, Helen; Crank, Helen; Harrop, Deborah; Hock, Emma; Copeland, Robert

2017-10-25

People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients' need and expectations. This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will be performed by two reviewers. Data will be extracted by one reviewer, tabled, and checked for accuracy by the second reviewer. The meta-ethnography approach by Noblit and Hare (Meta-ethnography: synthesizing qualitative studies 11, 1988) will be used to synthesise the data. This systematic review is expected to provide new insights into the experience of community-based group physical activity initiation for adults who have a serious mental illness to inform person-centred improvements to the management of serious mental illness through physical activity. The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 22/03/2017; (registration number CRD42017059948 ).

5 CFR 900.703 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

5 CFR 723.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

12 CFR 794.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

5 CFR 723.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

5 CFR 1207.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. (iii) Also, physical and mental impairment includes, but is not limited to, such diseases and...

5 CFR 900.703 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

45 CFR 707.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

31 CFR 17.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

5 CFR 723.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

45 CFR 707.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

5 CFR 900.703 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

10 CFR 1041.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

10 CFR 1041.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

31 CFR 17.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

Munchausen Syndrome by Proxy: Identification and Intervention

ERIC Educational Resources Information Center

Walk, Alexandra; Davies, Susan C.

2010-01-01

This article discusses the Munchausen syndrome by proxy (MSBP), also known as "factitious disorder by proxy" (FDBP) and fabricated and/or induced illness, which is a mental illness in which a person lies about the physical or mental well-being of a person he/she is responsible for. Most often the dynamic transpires between a mother and her child.…

Mental-health-related stigma among Japanese children and their parents and impact of renaming of schizophrenia.

PubMed

Koike, Shinsuke; Yamaguchi, Sosei; Ohta, Kazusa; Ojio, Yasutaka; Watanabe, Kei-Ichiro; Ando, Shuntaro

2017-03-01

Mental-health-related stigma affects help-seeking behavior and service utilization among young people. Whether mental-health-related stigma is different or correlated between parents and their children is unknown. It is also unknown whether the name change of schizophrenia in 2002 has had long-term effects on reducing stigma for adults in the general population. We recruited 143 parent-child pairs (mean ages [SD]: 51.5 [3.6] and 21.2 [1.2] years, respectively) to complete self-report questionnaires regarding mental-health-related stigma and experience. We also assessed negative stereotypes for three psychiatric disease names (old and new names of schizophrenia, and depression), and for diabetes mellitus as a physical illness comparison. The questionnaires also asked respondents to identify the old and new names of schizophrenia and dementia, respectively, among 10 names for mental and physical illnesses and conditions. Parents showed lower stigma levels toward mental illness and diabetes mellitus, but similar or greater stigma levels toward schizophrenia, compared with their children. Stigma levels toward mental illness in parents and their children were significantly correlated. The rate of correct identification of the old and new names for schizophrenia was higher in parents than in their children (64.7% vs 41.4%, P < 0.001). Parents who responded correctly endorsed more negative stereotypes toward the new name of schizophrenia compared with those who responded incorrectly (P = 0.049). The present findings suggest that stigma toward mental illness is shared between family members, and the name change of schizophrenia has effectively reduced stigma levels toward this disorder in adults of various ages. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

Risk factors for common mental disorders in women. Population-based longitudinal study.

PubMed

Patel, Vikram; Kirkwood, Betty R; Pednekar, Sulochana; Weiss, Helen; Mabey, David

2006-12-01

The determinants of common mental disorders in women have not been described in longitudinal studies from a low-income country. Population-based cohort study of 2494 women aged 18 to 50 years, in India. The Revised Clinical Interview Schedule was used for the detection of common mental disorders. There were 39 incident cases of common mental disorder in 2166 participants eligible for analysis (12-month rate 1.8%, 95% CI 1.3-2.4%). The following baseline factors were independently associated with the risk for common mental disorder: poverty (low income and having difficulty making ends meet); being married as compared with being single; use of tobacco; experiencing abnormal vaginal discharge; reporting a chronic physical illness; and having higher psychological symptom scores at baseline. Programmes to reduce the burden of common mental disorder in women should target poorer women, women with chronic physical illness and who have gynaecological symptoms, and women who use tobacco.

Inpatient charges and mental illness: Findings from the Nationwide Inpatient Sample 1999-2007.

PubMed

Banta, Jim E; Belk, Ivorie; Newton, Kedon; Sherzai, Abdullah

2010-01-01

Inpatient costs related to mental illness are substantial, though declining as a percentage of overall mental health treatment costs. The public sector has become increasingly involved in funding and providing mental health services. Nationwide Inpatient Sample data for the years 1999-2007 were used to: 1) examine Medicare, Medicaid, and private insurance charges related to mental illness hospitalizations, including trends over time; and 2) examine trends in mental comorbidity with physical illness and its effect on charges. There were an estimated 12.4 million mental illness discharges during the 9-year period, with Medicare being the primary payer for 4.3 million discharges, Medicaid for 3.3 million, private insurance for 3.2 million, and 1.6 million for all other payers. Mean inflation-adjusted charges per hospitalization were US$17,528, US$15,651, US$10,539, and US$11,663, respectively. Charges to public sources increased for schizophrenia and dementia-related discharges, with little private/public change noted for mood disorders. Comorbid mood disorders increased dramatically from 1.5 million discharges in 1999 to 3.4 million discharges in 2007. Comorbid illness was noted in 14.0% of the 342 million inpatient discharges during the study period and was associated with increased charges for some medical conditions and decreased charges for other medical conditions.

Mental health status and gender as risk factors for onset of physical illness over 10 years.

PubMed

Matheson, Flora I; Smith, Katherine L W; Moineddin, Rahim; Dunn, James R; Glazier, Richard H

2014-01-01

There is a growing interest in understanding the connection between mental illness (MI) and the onset of new physical illnesses among previously physically healthy individuals. Yet the role of gender is often forgotten in research focused on comorbidity of health problems. The objective of this study was to examine gender differences in the onset of physical illness in a cohort of respondents who met criteria for MI compared with a control cohort without mental health problems. This cohort study, conducted in Ontario, Canada, used a unique linked dataset with information from the 2000-2001 Canadian Community Health Survey and medical records (n=15,902). We used adjusted Cox proportional survival analysis to examine risk of onset of four physical health problems (chronic obstructive pulmonary disorder, asthma, hypertension and diabetes) for those with and without baseline MI across a 10-year period (2002-2011) among respondents aged 18-74 years. We controlled for socioeconomic and health indicators associated with health. The incidence of physical illness in the MI cohort was 28.5% among women and 29.9% among men (p=0.85) relative to controls (23.8% and 24%, respectively; p=0.48). Women in the MI cohort developed secondary physical health problems a year earlier than their male counterparts (p=0.002). Findings from the Cox proportional survival regression showed that women were at 14% reduced risk of developing physical illness, meaning that men were more disadvantaged (HR=0.89, CI 0.80 to 0.98). Those in the MI cohort were at 10 times greater risk of developing a secondary physical illness over the 10-year period (HR=1.10, CI 0.98 to 1.21). There was no significant interaction between gender and MI cohort (HR=1.05, CI 0.85 to 1.27). Policy and clinical practice have to be sensitive to these complex-needs patients. Gender-specific treatment and prevention practices can be developed to target those at higher risk of multiple health conditions.

Mental health status and gender as risk factors for onset of physical illness over 10 years

PubMed Central

Matheson, Flora I; Smith, Katherine L W; Moineddin, Rahim; Dunn, James R; Glazier, Richard H

2014-01-01

Background There is a growing interest in understanding the connection between mental illness (MI) and the onset of new physical illnesses among previously physically healthy individuals. Yet the role of gender is often forgotten in research focused on comorbidity of health problems. The objective of this study was to examine gender differences in the onset of physical illness in a cohort of respondents who met criteria for MI compared with a control cohort without mental health problems. Methods This cohort study, conducted in Ontario, Canada, used a unique linked dataset with information from the 2000–2001 Canadian Community Health Survey and medical records (n=15 902). We used adjusted Cox proportional survival analysis to examine risk of onset of four physical health problems (chronic obstructive pulmonary disorder, asthma, hypertension and diabetes) for those with and without baseline MI across a 10-year period (2002–2011) among respondents aged 18–74 years. We controlled for socioeconomic and health indicators associated with health. Results The incidence of physical illness in the MI cohort was 28.5% among women and 29.9% among men (p=0.85) relative to controls (23.8% and 24%, respectively; p=0.48). Women in the MI cohort developed secondary physical health problems a year earlier than their male counterparts (p=0.002). Findings from the Cox proportional survival regression showed that women were at 14% reduced risk of developing physical illness, meaning that men were more disadvantaged (HR=0.89, CI 0.80 to 0.98). Those in the MI cohort were at 10 times greater risk of developing a secondary physical illness over the 10-year period (HR=1.10, CI 0.98 to 1.21). There was no significant interaction between gender and MI cohort (HR=1.05, CI 0.85 to 1.27). Conclusions Policy and clinical practice have to be sensitive to these complex-needs patients. Gender-specific treatment and prevention practices can be developed to target those at higher risk of multiple health conditions. PMID:24014840

29 CFR 4907.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

1 CFR 457.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

1 CFR 457.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

36 CFR § 1154.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

29 CFR 4907.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

5 CFR 1636.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

34 CFR 1200.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

34 CFR 1200.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

36 CFR § 909.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and...

20 CFR 365.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

29 CFR 4907.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

1 CFR 457.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

20 CFR 365.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

22 CFR 1701.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

20 CFR 365.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

Responding to challenges for people with psychotic illness: Updated evidence from the Survey of High Impact Psychosis.

PubMed

Morgan, Vera A; Waterreus, Anna; Carr, Vaughan; Castle, David; Cohen, Martin; Harvey, Carol; Galletly, Cherrie; Mackinnon, Andrew; McGorry, Patrick; McGrath, John J; Neil, Amanda L; Saw, Suzy; Badcock, Johanna C; Foley, Debra L; Waghorn, Geoff; Coker, Sarah; Jablensky, Assen

2017-02-01

The objective is to summarise recent findings from the 2010 Australian Survey of High Impact Psychosis (SHIP) and examine their implications for future policy and planning to improve mental health, physical health and other circumstances of people with a psychotic disorder. Survey of High Impact Psychosis collected nationally representative data on 1825 people with psychotic illness. Over 60 papers have been published covering key challenges reported by participants: financial problems, loneliness and social isolation, unemployment, poor physical health, uncontrolled symptoms of mental illness, and lack of stable, suitable housing. Findings are summarised under the rubric of participant-ranked top challenges. The main income source for the majority (85%) of participants was a government benefit. Only one-third was employed, and the most appropriate employment services for this group were under-utilised. High rates of loneliness and social isolation impacted mental and physical health. The rate of cardiometabolic disease was well above the general population rate, and associated risk factors were present from a very young age. Childhood abuse (30.6%), adult violent victimisation (16.4%) and alcohol and substance abuse/dependence (lifetime rates of 50.5% and 54.5%, respectively) complicated the clinical profile. Treatment with medication was suboptimal, with physical health conditions undertreated, a high rate of psychotropic polypharmacy and underutilisation of clozapine in chronic persistent psychotic illness. Only 38.6% received evidence-based psychosocial therapies. In the previous year, 27.4% had changed housing and 12.8% had been homeless, on average for 155 days. Money, social engagement and employment are the most important challenges for people with psychotic illness, as well as good physical and mental health. An integrated approach to recovery is needed to optimise service delivery and augment evidence-based clinical practice with measures to improve physical health and social circumstances. Meeting these challenges has the potential to reduce costs to government and society, as well as promote recovery.

Motivation for physical activity and exercise in severe mental illness: A systematic review of cross-sectional studies.

PubMed

Farholm, Anders; Sørensen, Marit

2016-04-01

Individuals with severe mental illness (SMI) are less physically active than the general population. One important barrier contributing to this inactivity is lack of motivation. The aim of this paper is to systematically review all cross-sectional literature on motivation for physical activity among people with SMI and to use the results as basis for guidance on how mental health nurses can facilitate motivation for physical activity. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they included participants with SMI and reported data on motivation for physical activity. In total, 21 articles were included and over half them were published in 2011 or later. The present results indicate preliminary evidence of how the motivational processes do not differ between individuals with SMI and the general population, and that they are independent of diagnosis, medication, age, gender, and body mass index. Results from the current systematic review can give some tentative guidance on how to facilitate motivation for physical activity within mental health-care. However, there is still a great need for developing and examining practical strategies that can enhance adoption and adherence of physical activity among people with SMI. © 2016 Australian College of Mental Health Nurses Inc.

Schizophrenia and Physical Comorbidity.

PubMed

Šimunović Filipčić, Ivona; Filipčić, Igor

2018-06-01

Schizophrenia is a severe psychiatric disorder increasingly recognized as a systemic disorder. In addition to the burden and suffering caused by the mental illness itself, individuals with schizophrenia have a high risk for physical illnesses. The life expectancy gap remains 13 to 30 years wider in people with schizophrenia compared to the general population. This premature mortality is caused largely by deaths due to cardiovascular disease, cancer, diabetes mellitus, and other natural causes, poor diagnosis and treatment, and insufficient prevention of modifiable risk factors. Although the links between schizophrenia and physical illnesses are well established, in clinical practice, physical illnesses in patients with schizophrenia are often overlooked, and the mortality gap between general population and people with schizophrenia continues to widen. The physical health of people with schizophrenia is commonly self-neglected but also ignored by people around them and by health systems, resulting in significant physical health disparities and limited access to health services. The root of the problem of insufficient healthcare appear to lie in interrelated contributory factors from illness, patients, and medical and mental healthcare system. Furthermore, a growing body of literature has been indicating the effect of the chronic physical illness on the treatment outcome of psychosis. Premature mortality and disability could be reduced if there was a greater focus on the implementation of strategies that effectively prevent modifiable risk factors from the first psychotic episode and enhance early recognition of physical illnesses, reduce the burden of physical comorbidity and lead to improved health outcomes. Ultimately, to improve treatment outcome and to reduce the suffering of people with schizophrenia, it is crucial to treat physical comorbidity promptly and assertively from the appearance of the first symptoms of the psychotic disorder. The integrative approach and collaborative care within all levels of healthcare providers should be the imperative in clinical practice.

Pursuing minimally disruptive medicine: disruption from illness and health care-related demands is correlated with patient capacity.

PubMed

Boehmer, Kasey R; Shippee, Nathan D; Beebe, Timothy J; Montori, Victor M

2016-06-01

Chronic conditions burden patients with illness and treatments. We know little about the disruption of life by the work of dialysis in relation to the resources patients can mobilize, that is, their capacity, to deal with such demands. We sought to determine the disruption of life by dialysis and its relation to patient capacity to cope. We administered a survey to 137 patients on dialysis at an academic medical center. We captured disruption from illness and treatment, and physical, mental, personal, social, financial, and environmental aspects of patient capacity using validated scales. Covariates included number of prescriptions, hours spent on health care, existence of dependents, age, sex, and income level. On average, patients reported levels of capacity and disruption comparable to published levels. In multivariate regression models, limited physical, financial, and mental capacity were significantly associated with greater disruption. Patients in the top quartile of disruption had lower-than-expected physical, financial, and mental capacity. Our sample generally had capacity comparable to other populations and may be able to meet the demands imposed by treatment. Those with reduced physical, financial, and mental capacity reported higher disruption and represent a vulnerable group that may benefit from innovations in minimally disruptive medicine. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

1 CFR 457.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

12 CFR 794.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

31 CFR 17.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and..., performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3) Has a...

22 CFR 711.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

22 CFR 1005.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

5 CFR 723.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

29 CFR 4907.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

45 CFR 606.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

10 CFR 4.503 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

5 CFR 900.703 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and..., performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3) Has a...

20 CFR 365.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

10 CFR 1041.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such diseases and..., performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3) Has a...

32 CFR 1699.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical or mental impairment includes, but is not limited to, such disease and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management...

29 CFR 100.503 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

29 CFR 100.503 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

45 CFR 1803.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

7 CFR 15e.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

7 CFR 15e.103 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

41 CFR 51-10.103 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, and... disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and...

45 CFR 1803.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

7 CFR 15e.103 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

29 CFR 100.503 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic...

Scoping review of research in Australia on the co-occurrence of physical and serious mental illness and integrated care.

PubMed

Happell, Brenda; Galletly, Cherrie; Castle, David; Platania-Phung, Chris; Stanton, Robert; Scott, David; McKenna, Brian; Millar, Freyja; Liu, Dennis; Browne, Matthew; Furness, Trentham

2015-10-01

The physical health of people with serious mental illness (SMI) has become a focal area of research. The aim of the present study was to ascertain the attention and distribution of research from within Australia on physical illness and SMI co-occurrence, and to identify gaps. A scoping review of peer-reviewed research literature from Australia, published between January 2000 and March 2014, was undertaken through an electronic literature search and coding of papers to chart trends. Four trends are highlighted: (i) an almost threefold increase in publications per year from 2000-2006 to 2007-2013; (ii) a steady release of literature reviews, especially from 2010; (iii) health-related behaviours, smoking, integrated-care programmes, and antipsychotic side-effects as the most common topics presented; and (iv) paucity of randomized, controlled trials on integrated-care models. Despite a marked increase in research attention to poorer physical health, there remains a large gap between research and the scale of the problem previously identified. More papers were descriptive or reviews, rather than evaluations of interventions. To foster more research, 12 research gaps are outlined. Addressing these gaps will facilitate the reduction of inequalities in physical health for people with SMI. Mental health nurses are well placed to lead multidisciplinary, consumer-informed research in this area. © 2015 Australian College of Mental Health Nurses Inc.

Computerized physical activity training for persons with severe mental illness - experiences from a communal supported housing project.

PubMed

Gyllensten, Amanda Lundvik; Forsberg, Karl-Anton

2017-11-01

To study the effectiveness of Exergames in communal psychiatry for persons with severe mental illness, a randomized cluster study was performed. The hypothesis was to increase physical activity habits to improve somatic health. To identify factors promoting or impeding the use of the Exergames. Assessments of BMI, blood pressure, physical fitness, SF36, GAF and social interactions were studied at baseline and 10 months. An integrated methods design using content analysis of focus group interviews was integrated with a statistical analysis. Forty-three persons were randomized to the intervention and 30 to the control group. The qualitative interviews included 18 users, 11 staffs and one technical assistant. There were no significant between-group changes in physical activity behaviours or somatic health parameters after 10 months. Only 5% of the intervention group made systematic use of the intervention. Technological difficulties and staff attitudes were found to be barriers. The Exergames were perceived as technically complicated. The staff did not see playing TV games as important and negative attitudes were found. Exergames was not a successful intervention to increase physical activity behaviours in persons with severe mental illness in the community. Exergames and motivation for physical activity in this group is problematic. Implications for rehabilitation There are difficulties to change passive physical activity habits for persons with severe mental illness, living in sheltered housing conditions in the community due to negative symptoms with depression, low motivation and bad self -confidence. An exergame intervention was not successful in this group of persons. No somatic health benefits were found. Simple physical activities and offering different choices meeting different user needs should be offered. Ensuring user and staff engagement, good technical knowledge and good monitoring is a need for a successful intervention, if Exergames are offered as an alternative physical activity.

Reliability and Validity of a Physical Capacity Evaluation Used to Assess Individuals with Intellectual Disabilities and Mental Illness

ERIC Educational Resources Information Center

Jang, Yuh; Chang, Tzyh-Chyang; Lin, Keh-Chung

2009-01-01

Physical capacity evaluations (PCEs) are important and frequently offered services in work practice. This study investigates the reliability and validity of the National Taiwan University Hospital Physical Capacity Evaluation (NTUH PCE) on a sample of 149 participants consisted of three groups: 45 intellectual disability (ID), 56 mental illness…

Educational nurse-led lifestyle intervention for persons with mental illness.

PubMed

Rönngren, Ylva; Björk, Annette; Audulv, Åsa; Enmarker, Ingela; Kristiansen, Lisbeth; Haage, David

2018-06-01

Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention. © 2017 Australian College of Mental Health Nurses Inc.

Gender and age group differences in suicide risk associated with co-morbid physical and psychiatric disorders in older adults.

PubMed

Vasiliadis, Helen-Maria; Lamoureux-Lamarche, Catherine; Gontijo Guerra, Samantha

2017-02-01

It is unclear whether health service use influences the association between psychiatric and physical co-morbidity and suicide risk in older adults. Controls were older adults (n = 2,494) participating in a longitudinal study on the health of the elderly carried out between 2004 and 2007, in Quebec. The cases were all suicide decedents (n = 493) between 2004 and 2007, confirmed by the Quebec Coroner's office. Multivariate analyses were carried out to test the association between suicide and the presence of psychiatric and physical illnesses controlling for health service use and socio-demographic factors by gender and age group. Interaction terms were also tested between suicide and co-morbidity on outpatient service use. The presence of physical illnesses only, was associated with a reduced risk of suicide across all sex and age groups. The presence of a mental disorder only was associated with an increased risk of suicide overall and specifically in females and those aged 70 to 84 years of age. Suicide risk was lower in those with a psychiatric and physical co-morbidity and consulting mental health services. Increased mental health follow-up in older adults with psychiatric illnesses is needed for the detection of suicidal behavior and reducing suicide risk in males. Further research should focus on the mitigating effect of the presence of physical illnesses on stigma and health service use and the presence of social support in the elderly.

Physical activity and sedentary behaviour among inpatient adults with mental illness.

PubMed

Fraser, Sarah J; Chapman, Justin J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2016-08-01

The aim of this study was to assess levels and patterns of physical activity and sedentary behaviour among inpatient adults with mental illness. Cross-sectional. 101 participants completed questionnaires on time spent in walking, moderate- and vigorous-intensity activity in the past week and domain specific sitting time on a usual weekday and weekend day. 36 participants also provided valid accelerometry data. Regression analyses were used to explore associations between MVPA and sedentary behaviour and explanatory variables of gender, age, education, body mass index and psychological distress. Self-report data indicated median of 32min/day (IQR: 14.46-85.71) in weighted MVPA and a median of 761min/day (12.7h) (IQR: 552.43-917.14) in sedentary behaviour. Accelerometry data indicated an average of 115min/day in light activity, 37min/day in MVPA and 664min/day (11.1h) in sedentary behaviour. Bivariate analyses indicated no significant associations between explanatory variables and MVPA and sedentary behaviour. Inpatient adults with mental illness can be physically active, with walking comprising the major component of MVPA time. Inpatient adults with mental illness spend a significant amount of time sitting; intervention strategies could focus on reducing the time spent sitting in general relaxation and doing nothing. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review.

PubMed

Bennett, Sophie; Shafran, Roz; Coughtrey, Anna; Walker, Susan; Heyman, Isobel

2015-04-01

Children with chronic physical illness are significantly more likely to develop common psychiatric symptoms than otherwise healthy children. These children therefore warrant effective integrated healthcare yet it is not established whether the known, effective, psychological treatments for symptoms of common childhood mental health disorders work in children with chronic physical illness. EMBASE, MEDLINE, PsycINFO and CINAHL databases were searched with predefined terms relating to evidence-based psychological interventions for psychiatric symptoms in children with chronic physical illness. We included all studies (randomised and non-randomised designs) investigating interventions aimed primarily at treating common psychiatric symptoms in children with a chronic physical illness in the review. Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality analysis. Ten studies (209 children, including 70 in control groups) met the criteria for inclusion in the review. All studies demonstrated some positive outcomes of cognitive behavioural therapy for the treatment of psychiatric symptoms in children with chronic physical illness. Only two randomised controlled trials, both investigating interventions for symptoms of depression, were found. There is preliminary evidence that cognitive behavioural therapy has positive effects in the treatment of symptoms of depression and anxiety in children with chronic physical illness. However, the current evidence base is weak and fully powered randomised controlled trials are needed to establish the efficacy of psychological treatments in this vulnerable population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Association of Household Food Insecurity with the Mental and Physical Health of Low-Income Urban Ecuadorian Women with Children

PubMed Central

Armijos, Rodrigo X.; Racines, Marcia; Cevallos, William; Castro, Nancy P.

2016-01-01

Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition. PMID:27752266

Association of Household Food Insecurity with the Mental and Physical Health of Low-Income Urban Ecuadorian Women with Children.

PubMed

Weigel, M Margaret; Armijos, Rodrigo X; Racines, Marcia; Cevallos, William; Castro, Nancy P

2016-01-01

Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition.

Mental Health Consumer Experiences and Strategies When Seeking Physical Health Care

PubMed Central

Ewart, Stephanie B.; Bocking, Julia; Happell, Brenda; Platania-Phung, Chris; Stanton, Robert

2016-01-01

People with mental illness have higher rates of physical health problems and consequently live significantly shorter lives. This issue is not yet viewed as a national health priority and research about mental health consumer views on accessing physical health care is lacking. The aim of this study is to explore the experience of mental health consumers in utilizing health services for physical health needs. Qualitative exploratory design was utilized. Semistructured focus groups were held with 31 consumer participants. Thematic analysis revealed that three main themes emerged: scarcity of physical health care, with problems accessing diagnosis, advice or treatment for physical health problems; disempowerment due to scarcity of physical health care; and tenuous empowerment describing survival resistance strategies utilized. Mental health consumers were concerned about physical health and the nonresponsive health system. A specialist physical health nurse consultant within mental health services should potentially redress this gap in health care provision. PMID:28462330

5 CFR 1207.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE MERIT SYSTEMS PROTECTION... a disability means any person who has a physical or mental impairment that substantially limits one... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

41 CFR 51-10.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and... self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. (3...

32 CFR 1906.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not limited to, such diseases and..., performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working; (3) Has a...

32 CFR 1807.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COUNTERINTELLIGENCE... real or personal property. Individual with disabilities means any person who has a physical or mental... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

32 CFR 191.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... on race, color, national origin, religion, sex, age, or disability. Equal Employment Opportunity (EEO... characteristics of a national origin group. People with disabilities. People who have physical or mental..., such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

Illness perceptions in anorexia nervosa: a qualitative investigation.

PubMed

Higbed, Laurie; Fox, John R E

2010-09-01

Anorexia nervosa (AN) is an eating disorder characterized by the egosyntonic nature of symptoms, denial of illness, and ambivalence about treatment engagement. Within the physical health literature, people's beliefs about their illness have been found to impact upon coping and treatment outcomes and this has largely been explored using the self-regulation model. This model has also been applied to mental health and more recently to AN, with beliefs about the disorder being associated with readiness to change. However, qualitative investigations have indicated that physical health models have limited applicability for assessing people's beliefs about mental illness. This may be particularly pertinent to AN, given the complexity of the disorder. Therefore, this study explored illness perceptions in AN using a qualitative design which was not restricted by a physical illness model but focused on personal models of AN from the perspective of those experiencing the disorder. Semi-structured interviews were conducted with thirteen participants who were currently in treatment for AN. Interview transcripts were analysed using grounded theory methodology. An interpretative theory of illness perceptions in AN was developed and comprised four related categories: 'making sense of AN', 'the relationship between AN and the self', 'the recovery struggle', and 'coping with treatment'. Patient's accounts transcended the dimensions offered by physical illness models, with the implication that methods for assessing illness beliefs in AN require adaptation for a full understanding to be gained and the complexity of perceptions to be captured.

42 CFR 440.130 - Diagnostic, screening, preventive, and rehabilitative services.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Promote physical and mental health and efficiency. (d) “Rehabilitative services,” except as otherwise... reduction of physical or mental disability and restoration of a recipient to his best possible functional... under State law, to enable him to identify the existence, nature, or extent of illness, injury, or other...

Type, Rather than Number, of Mental and Physical Comorbidities Increases the Severity of Symptoms in Patients with Irritable Bowel Syndrome

PubMed Central

Lackner, Jeffrey M.; Ma, Chang-Xing; Keefer, Laurie A.; Brenner, Darren M.; Gudleski, Gregory D.; Satchidanand, Nikhil; Firth, Rebecca; Sitrin, Michael D.; Katz, Leonard; Krasner, Susan S.; Ballou, Sarah K; Naliboff, Bruce D.; Mayer, Emeran A.

2013-01-01

BACKGROUND Irritable bowel syndrome (IBS) has significant mental and physical comorbidities. However, little is known about the day-to-day burden these comorbidities place on quality of life (QOL), physical and mental function, distress, and symptoms of patients. METHODS We collected cross sectional data from 175 patients with IBS, diagnosed based on Rome III criteria (median age, 41 y; 78% women), referred to 2 specialty care clinics. Patients completed psychiatric interviews, a physical comorbidity checklist, the IBS symptom severity scale, the IBS quality of life instrument, the brief symptom inventory, the abdominal pain intensity scale, and the SF-12 health survey. RESULTS Patients with IBS reported an average of 5 comorbidities (1 mental, 4 physical). Subjects with more comorbidities reported worse QOL after adjusting for confounding variables. Multiple linear regression analyses indicated that comorbidity type was more consistently and strongly associated with illness burden indicators than disease counts. Of 10, 296 possible physical–mental comorbidity pairs, 6 of the 10 most frequent dyads involved specific conditions (generalized anxiety, depression, back pain, agoraphobia, tension headache, insomnia). These combinations were consistently associated with greater illness and symptom burdens (QOL, mental and physical function, distress, more severe symptoms of IBS, pain). CONCLUSIONS Comorbidities are common among patients with IBS. They are associated with distress and reduced QOL. Specific comorbidities are associated with more severe symptoms of IBS. PMID:23524278

General physical health advice for people with serious mental illness.

PubMed

Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-03-28

There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To review the effects of general physical healthcare advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (last update search October 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and registries of Clinical Trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised clinical trials focusing on general physical health advice for people with serious mental illness.. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. Seven studies are now included in this review. For the comparison of physical healthcare advice versus standard care we identified six studies (total n = 964) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.20, CI -0.47 to 0.87, very low quality of evidence) but another two did for the Quality of Life Medical Outcomes Scale - mental component (n = 487, 2 RCTs, MD 3.70, CI 1.76 to 5.64). There was no difference between groups for the outcome of death (n = 487, 2 RCTs, RR 0.98, CI 0.27 to 3.56, low quality of evidence). For service use two studies presented favourable results for health advice, uptake of ill-health prevention services was significantly greater in the advice group (n = 363, 1 RCT, MD 36.90, CI 33.07 to 40.73) and service use: one or more primary care visit was significantly higher in the advice group (n = 80, 1 RCT, RR 1.77, CI 1.09 to 2.85). Economic data were equivocal. Attrition was large (> 30%) but similar for both groups (n = 964, 6 RCTs, RR 1.11, CI 0.92 to 1.35). Comparisons of one type of physical healthcare advice with another were grossly underpowered and equivocal. General physical health could lead to people with serious mental illness accessing more health services which, in turn, could mean they see longer-term benefits such as reduced mortality or morbidity. On the other hand, it is possible clinicians are expending much effort, time and financial resources on giving ineffective advice. The main results in this review are based on low or very low quality data. There is some limited and poor quality evidence that the provision of general physical healthcare advice can improve health-related quality of life in the mental component but not the physical component, but this evidence is based on data from one study only. This is an important area for good research reporting outcome of interest to carers and people with serious illnesses as well as researchers and fundholders.

European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS): background, aims and methods

PubMed Central

Weiser, Prisca; Becker, Thomas; Losert, Carolin; Alptekin, Köksal; Berti, Loretta; Burti, Lorenzo; Burton, Alexandra; Dernovsek, Mojca; Dragomirecka, Eva; Freidl, Marion; Friedrich, Fabian; Genova, Aneta; Germanavicius, Arunas; Halis, Ulaş; Henderson, John; Hjorth, Peter; Lai, Taavi; Larsen, Jens Ivar; Lech, Katarzyna; Lucas, Ramona; Marginean, Roxana; McDaid, David; Mladenova, Maya; Munk-Jørgensen, Povl; Paziuc, Alexandru; Paziuc, Petronela; Priebe, Stefan; Prot-Klinger, Katarzyna; Wancata, Johannes; Kilian, Reinhold

2009-01-01

Background People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions. Methods and design HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet country-specific needs, and (iii) at identifying best practice across Europe. Criteria for best practice will include evidence on the efficacy of physical health interventions and of their effectiveness in routine care, cost implications and feasibility for adaptation and implementation of interventions across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities. Meanwhile a multi-disciplinary network consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well as to hold resonance for community dwelling people with mental health problems. Discussion A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider heterogeneity of mental disorders, the multitude of physical health problems, health-relevant behaviour, health-related attitudes, health-relevant living conditions, and resource levels in mental health and social care facilities. PMID:19715560

Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia - a qualitative exploratory study.

PubMed

von Kardorff, Ernst; Soltaninejad, Ali; Kamali, Mohammad; Eslami Shahrbabaki, Mahin

2016-01-01

Caregivers of people with mental illnesses often experience a wide range of burdens. Although many studies have confirmed burdens among family caregivers of mentally ill relatives in general, specific knowledge regarding the concrete everyday hassle and existential sorrows from the caregiverś subjective reasoning perspective is lacking. Furthermore, there is little evidence on the possible different effects of affective disorders and schizophrenia on the quality of burden; this is also true with regard to the role of cultural traditions and lay beliefs. The aim of this study was to explore the specific burdens experienced by caregivers of patients with schizophrenia and affective disorders. A qualitative study was conducted by semi-structured interviews with 45 caregivers of patients with schizophrenia and affective disorders. Data were analysed by qualitative content analysis. Eleven encumbering themes resulted from the interviews including incertitude, unawareness, emotional burden, stigma and blame, financial burden, physical burden, restriction in routine, disruption in routine, dissatisfaction with family, relatives, and acquaintances, troubles with patients' adherence to medication, and problems with health services and governmental support. Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.

Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population

PubMed Central

Pang, Shirlene; Liu, Jianlin; Mahesh, Mithila; Chua, Boon Yiang; Shahwan, Shazana; Lee, Siau Pheng; Vaingankar, Janhavi Ajit; Abdin, Edimansyah; Fung, Daniel Shuen Sheng; Chong, Siow Ann; Subramaniam, Mythily

2017-01-01

Objectives Stigma against mental illnesses is one of the significant obstacles faced by mental health service users and providers. It can develop at a young age and is also influenced by culture. Youths in Southeast Asian countries are under-represented in mental health research, thus this study aims to explore the dimensions of stigma and social tolerance and examine its correlates in the younger, multiethnic population of Singapore. Design An online survey collected data with sociodemographic questions, the Attitudes Towards Serious Mental Illness (Adolescent version) Scale, Social Tolerance Scale and an open-text question on words or phrases participants associated with the term ‘mental illness’. Principal component analysis and multiple regression models were conducted to investigate the factor structure of the attitudes and social tolerance scales and their sociodemographic correlates. Participants Participants included 940 youths aged 14–18 years old who were residing in Singapore at the time of the survey and were recruited through local schools. Results About a quarter of the students (22.6%) reported participating in mental health awareness campaigns while nearly half (44.5%) associated pejorative words and phrases with the term mental illness. The Attitudes Towards Serious Mental Illness (Adolescent version) Scale yielded five factors while the Social Tolerance Scale yielded two. Ethnicity, gender and nationality were significantly correlated with factors of both scales. Chinese youths showed higher sense of ’physical threat' and lower ’social tolerance' than those of other ethnicities. Females showed more ’wishful thinking', ’social concern' and ’social responsibility' towards the mentally ill than males. Conclusions The dimensions of stigma and social tolerance are different in Asian cultures compared with Western cultures. Sociodemographic differences in attitudes towards the mentally ill were found among youths living in Singapore. Misconceptions and negative attitudes towards mental illness are common, demonstrating a clear need for effective stigma reduction campaigns. PMID:29042379

Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness.

PubMed

Buckley, Peter F

2006-01-01

The co-occurrence of a severe mental illness and a substance use or abuse disorder is common in the United States as well as internationally and could be considered as more the expectation than the exception when assessing patients with serious mental illness. Substance use disorders can occur at any phase of the mental illness, perhaps even inducing psychosis. Causes of this comorbidity may include self-medication, genetic vulnerability, environment or lifestyle, underlying shared origins, and/or a common neural substrate. The consequences of dual diagnosis include poor medication compliance, physical comorbidities and poor health, poor self-care, increased suicide risk or aggression, increased sexual behavior, and possible incarceration. All of these factors contribute to a greater health burden, which reduces the health care system's capacity to adequately treat patients. Therefore, screening, assessment, and integrated treatment plans for dual diagnosis that can address both the addiction disorder and the mental illness are recommended in order to provide accurate treatment, after-care, and other health care to accommodate patients' social and vocational needs.

Policy reform dilemmas in promoting employment of persons with severe mental illness.

PubMed

Noble, J H

1998-06-01

Recent evaluations by the U.S. General Accounting Office and the National Alliance for the Mentally Ill of reemployment efforts of the federal-state vocational rehabilitation program found that services offered by state vocational rehabilitation agencies do not produce long-term earnings for clients with emotional or physical disabilities. This paper examines reasons for these poor outcomes and the implications of recent policy reform recommendations. Congress must decide whether to take action at the federal level to upgrade programs affecting persons with severe mental illnesses or to continue to rely on state decision making. The federal-state program largely wastes an estimated $490 million annually on time-limited services to consumers with mental illnesses. Rechanneled into a variety of innovative and more appropriate integrated services models, the money could buy stable annual vocational rehabilitation funding for 62,000 to 90,000 consumers with severe mental illnesses. Larger macrosystem problems involve the dynamics of the labor market that limit job opportunities and the powerful work disincentives for consumers with severe disabilities now inherent in Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid.

Correlates of Mental Illness and Health Categories among Older Adults in China: An Empirical Study Based on the Two Continua Model.

PubMed

Jiang, Nan; Lu, Nan

2018-04-30

Keyes' two continua model is a useful concept in which mental health and mental illness exist on two separate axes. Based on this model, this study examined the prevalence and correlates of three mental health categories among older adults in China. Cross-sectional data were derived from Wave 1 of the Study on Global AGEing and Adult Health. Participants were categorized into complete mental health (CMH), complete mental illness (CMI), and moderate mental health (MMH) groups. Multinomial logistic regressions were used. The prevalence of CMH, CMI, and MMH in China was 18%, 16%, and 66%, respectively. Being female, unmarried, younger, and feeling unhealthy were more likely to result in placement in the CMI category. Employment, education, and cognitive function were identified as important protective factors of CMH. Age, income, urban or rural residence, and physical function difficulty were associated with all three categories. We demonstrated the utility of the two continua model in identifying mental health needs in Chinese contexts. The findings suggest that future policy reforms and clinical interventions should establish a more comprehensive mental health category as a screening tool nationwide. The promotion of social engagement could play an important role in treating mental illness and improving positive mental health.

The Family Challenge of Caring for the Chronically Mentally Ill: A Phenomenological Study

PubMed Central

Shamsaei, Farshid; Cheraghi, Fatemeh; Esmaeilli, Ravanbakhsh

2015-01-01

Background: Family caregiving for patients with chronic mental illness is influenced by various factors such as political, socioeconomic, and cultural contexts as well as related policies and health services. Objectives: The purpose of this study was to explore the challenges with which the family caregivers of patients with chronic mental illness have to contend. Materials and Methods: The research design was qualitative with a phenomenological approach. The research population consisted of 16 long-term carers expressing interest in participating in the project. The carers were the family members of mentally ill relatives who collected their monthly medications at Farshchian Psychiatry Hospital in Hamadan in 2012. Purposive sampling was used to draw the sample. Data were collected by individual in-depth semi-structured interviews, which were tape-recorded and analyzed via Colaizzi’s phenomenological method. Rigor was assessed regarding credibility, dependability, conformability, and transferability. Results: Our findings highlighted 4 main themes, namely stress and emotional distress, need for education and information, socioeconomic effects and support, and physical strain. Conclusions: Families experience frustrations when providing support and care to their mentally ill relatives. They, therefore, need appropriate support and intervention by mental health services. PMID:26576169

Differentiation of direct and indirect socioeconomic effects on suicide attempts in South Korea

PubMed Central

Ki, Myung; Seong Sohn, Eui; An, Byungduck; Lim, Jiseun

2017-01-01

Abstract Despite the wide recognition of the inverse association between socioeconomic position (SEP) and suicidal behaviors, its underlying process and potential mediators are little known. This study investigated the pathway from SEP to suicide attempts with attention to potential mediators. From the Korean Health and Nutrition Examination Survey 2007–2013, which is a nationwide cross-sectional survey of the health and nutritional status, a total of 34,565 participants (≥30 years) were included in the analysis. To unfold the pathways linking SEP to suicide attempts, the direct and indirect effects of 3 SEP measures (educational attainment, household income, and occupational group) and 3 mediators (physical illness, mental health problems, and problematic drinking) were differentiated using structured equation model (SEM). Most of direct and indirect effects of educational attainment, household income, and occupational group on suicide attempts were significant; Nonemployment status had the largest total (β = 0.291, P < .01) and direct effects (β = 0.212, P < .01), while educational attainment had the largest indirect effect (β = −0.124, P < .01). Educational attainment was mainly mediated by physical illness and problem drinking, whereas household income and occupational group were mainly mediated by anxious or depressed mood and problem drinking. Physical illness played a major role in explaining suicide attempts, compared to mental health problem and problem drinking. Overall, experience of socioeconomic disadvantage increased suicide attempts independently of mental and physical problems. An extension of suicide prevention program is required for comprehensively targeting people with general problems such as physical illness and low SEP, complemented to narrowly targeting high risk group with, such as mental health problem. PMID:29390510

25 CFR 20.315 - Who is not covered by the employment policy?

Code of Federal Regulations, 2010 CFR

2010-04-01

... the home who has a physical or mental impairment A physician or certified psychologist verifies the... from a temporary medical injury or illness It is documented in the case plan that the illness or injury... Income (SSI) assistance A physician, psychologist, or social services worker certifies that a physical or...

A systematic review of the effects of novel psychoactive substances 'legal highs' on people with severe mental illness.

PubMed

Gray, R; Bressington, D; Hughes, E; Ivanecka, A

2016-06-01

WHAT IS KNOWN ON THE SUBJECT?: Novel psychoactive substances (NPS) include synthetic drugs mimicking the effects of illicit drugs, e.g. synthetic cannabinoids, and herbs such as Salvia divinorum. NPS are substances that can trigger hallucinations and other effects altering the mind, and are currently uncontrolled by the United Nations' 1961 Narcotic Drugs/1971 Psychotropic Substances Conventions. NPS affect brain chemistry that induces the psychoactive effects, such as hallucinations and feeling 'high'. It is unknown what effects such drugs have on people with severe mental illness (i.e. psychotic illnesses). WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our review demonstrates that little is known about the effects of various NPS on people with severe mental illness. Almost nothing is known about the long-term consequences of NPS use on the mental and physical health of SMI patients. Patients may lack understanding that NPS are psychoactive drugs that can impact on their mental and physical wellbeing. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Some patients might be reluctant or do not think it is relevant to disclose NPS use. Commonly used illicit drug screening is unlikely to detect the presence of NPS, therefore health and mental health professionals should directly enquire about NPS and actively encourage patients with severe mental illness to disclose any substance use. There was no significant patient and public involvement in the development and conduct of this study . Introduction Novel psychoactive substances (NPS) are synthetic substances that have been developed to produce altered states of consciousness and perceptions. People with severe mental illness (SMI) are more likely to use NPS than people without mental illness, but the short- and long-term effects of NPS are largely unknown. Method We systematically reviewed the literature about the effects of NPS on people with SMI. Results We included 12 case reports, 1 cross-sectional survey and 1 qualitative study. Participants included mostly males aged between 20 and 35 years. A variety of NPS were used, including synthetic cathinones and herbs such as Salvia. The most commonly reported effects of NPS were psychotic symptoms (in some cases novel in form and content to the patients' usual symptoms) and significant changes in behaviour, including agitation, aggression and violence. Patients' vital signs, such as blood pressure, pulse rate and temperature, were also commonly affected. Conclusion NPS potentially have serious effects on people with SMI, but our findings have limited generalizability due to a reliance on case studies. There is a paucity of evidence about the long-term effects of these substances. Further research is required to provide a better understanding about how different NPS affect patients' mental and physical health. © 2016 John Wiley & Sons Ltd.

Stigma, agency and recovery amongst people with severe mental illness.

PubMed

Whitley, Rob; Campbell, Rosalyn Denise

2014-04-01

Evidence suggests that people with a severe mental illness still suffer high levels of stigma and discrimination. However little is known about how people with a severe mental illness manage such stigma. As such, the overall aim of this study is to document and analyze behavioral and psychological strategies of stigma management and control in a sample of people in recovery from a severe mental illness. To meet this aim, we conducted a five-year (2008-2012) qualitative longitudinal study in Washington D.C. Participants were recruited from small-scale congregate housing units ('recovery communities') for people in recovery, provided by a public mental health agency. We conducted regular focus groups at these communities, augmented by in-depth participant observation. Analysis was propelled by the grounded theory approach. A key finding of this study is that stigma and discrimination were not perceived as commonly experienced problems by participants. Instead, stigma and discrimination were perceived as omnipresent potential problems to which participants remained eternally vigilant, taking various preventive measures. Most notable among these measures was a concerted and self-conscious effort to behave and look 'normal'; through dress, appearance, conduct and demeanor. In this endeavor, participants possessed and deployed a considered degree of agency to prevent, avoid or preempt stigma and discrimination. These efforts appeared to have a strong semiotic dimension, as participants reported their developing 'normality' (and increased agentic power) was tangible proof of their ongoing recovery. Participants also routinely discussed severe mental illness in normative terms, noting its similarity to physical illnesses such as diabetes, or to generic mental health problems experienced by all. These behavioral and psychological strategies of normalization appeared to be consolidated within the recovery communities, which provided physical shelter and highly-valued peer support. This fostered participants' ability to face and embrace the outside world with confidence, pride and dignity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Facilitating knowledge of mental health nurses to undertake physical health interventions: a pre-test/post-test evaluation.

PubMed

Hemingway, Steve; Clifton, Andrew; Stephenson, John; Edward, Karen-Leigh

2014-04-01

The aim of this project was to develop and deliver an evidence-based educational package with a physical and mental health focus to clinicians and other health care workers in mental health settings. For individuals who experience mental disorders, pharmacotherapy is often considered as a first line of treatment. However, owing to adverse drug reactions and pre-existing physical conditions, outcomes for clients/service users may be compromised. Mortality and morbidity rates of people diagnosed with a serious mental illness caused by physical health conditions do not compare favourably with the general population. This paper reports on a physical skills project that was developed in collaboration between the University of Huddersfield and South West Yorkshire Partnership Foundation Trust. Pre-post study design: five workshops were conducted in the fields of intramuscular injections, diabetes, health improvement, oral health and wound care. A total of 180 pairs of questionnaires to assess practitioner and student skills and knowledge were administered to participants before and after workshops. All workshops resulted in a statistically significant improvement in subject skills and knowledge scores (P < 0.001 in all cases). Questionnaires also elicited participant satisfaction with the workshops: over 99% of participants reported being 'satisfied' or 'very satisfied' with the workshops. Mental health nurses are the largest group of registered practitioners working in the mental health setting and thus need to be harnessed to make a positive contribution to the improvement of the physical health status of service users with a serious mental illness. © 2014 John Wiley & Sons Ltd.

Internet-based cognitive behaviour therapy and physical exercise - Effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial.

PubMed

Strid, Catharina; Andersson, Claes; Forsell, Yvonne; Öjehagen, Agneta; Lundh, Lars-Gunnar

2016-11-01

Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p < .001, with weak-to-moderate effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different aspects of patients' health problems. The recruitment of participants was based on patients' interest and inclusion criteria which may have affect the generalizability. © 2016 The British Psychological Society.

Predicting Risk of Suicide Attempt Using History of Physical Illnesses From Electronic Medical Records

PubMed Central

Luo, Wei; Tran, Truyen; Berk, Michael; Venkatesh, Svetha

2016-01-01

Background Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk. Objective The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data. Methods We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC). Results The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians. Conclusions This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk. PMID:27400764

Description of a healthy lifestyle intervention for people with serious mental illness taking second-generation antipsychotics.

PubMed

Park, Tanya; Usher, Kim; Foster, Kim

2011-12-01

Weight gain and obesity has reached epidemic proportions, with the prevalence of metabolic syndrome (MetS) reaching 20-25% of the global population. MetS is a cluster of metabolic abnormalities, including weight gain, associated with an increased risk of cardiovascular disease, diabetes, and stroke. While individuals in the general population are at risk of physical conditions, such as MetS, people with mental illness are at even higher risk. The increased incidence of MetS for people with serious mental illness has been linked to the use of second-generation antipsychotic medication. This paper describes the content, structure, and development of 'Passport 4 Life', a healthy lifestyle intervention to maintain weight and prevent further weight gain for people with serious mental illness. While there are a number of diet and lifestyle programmes available for the general population, Passport 4 Life was specifically designed as an intervention to address the needs of people with serious mental illness taking second-generation antipsychotics. Passport 4 Life comprises 12 weekly group sessions that include the concepts and spirit of motivational interviewing, nutrition, and exercise education, combined with weekly exercise activity. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

'Old' and 'new' institutions for persons with mental illness: treatment, punishment or preventive confinement?

PubMed

Gostin, Lawrence O

2008-09-01

Despite countless promises for a better life by national commissions, governments and the international community, there has evolved a vicious cycle of neglect, abandonment, indignity, cruel and inhuman treatment, and punishment of persons with mental illness. This shameful history of benign, and sometimes malignant, neglect of persons with mental illness is well understood, with the deep stigma and unredressed discrimination, the deplorable living conditions, and the physical and social barriers preventing their integration and full participation in society. The maltreatment of this vulnerable population has been reinforced by the hurtful stereotypes of incompetency and dangerousness. The belief that persons with mental illness are uniformly dangerous is an equally harmful myth. It provides policy makers with an ostensible justification to exercise control over persons with mental illness, even if they have not committed a violent offence. However, research demonstrates that the class of persons with most mental illnesses is no more dangerous than other populations, and that the vast majority of violence is committed by persons without mental illness. This article will show how this vulnerable population has been unconscionably treated. First, the gross violations of human rights that have occurred, and continue to occur, in 'old' psychiatric institutions will be examined. The deinstitutionalization movement, however, resulted in new places of confinement for this population, such as jails, prisons and homeless shelters. The second part of this paper will explore the new realities of criminal confinement of persons with mental illness. As we will see, incarceration of this vulnerable population in the criminal justice system has caused enormous suffering. If Dostoyevsky was correct that the 'degree of civilization... can be judged by entering its prisons', then by that measure, we are a deeply uncivilized society.

The relationship between physical inactivity and mental wellbeing: Findings from a gamification-based community-wide physical activity intervention

PubMed Central

Harris, Marc Ashley

2018-01-01

Mental ill health accounts for 13 per cent of total global disease burden with predictions that depression alone will be the leading cause of disease burden globally by 2030. Poor mental health is consistently associated with deprivation, low income, unemployment, poor education, poorer physical health and increased health-risk behaviour. A plethora of research has examined the relationship between physical activity and mental wellbeing; however, the influence of community-wide gamification-based physical activity interventions on mental wellbeing, to the authors’ knowledge, is yet to be explored. In view of this paucity of attention, the current study examined the relationship between physical activity and mental wellbeing pre/post a community-wide, gamification-based intervention. The findings revealed that increases in mental wellbeing were significantly greater for the least active prior to the intervention, and a strong, positive correlation between increase in physical activity and increase in mental wellbeing was observed. PMID:29372067

The relationship between physical inactivity and mental wellbeing: Findings from a gamification-based community-wide physical activity intervention.

PubMed

Harris, Marc Ashley

2018-01-01

Mental ill health accounts for 13 per cent of total global disease burden with predictions that depression alone will be the leading cause of disease burden globally by 2030. Poor mental health is consistently associated with deprivation, low income, unemployment, poor education, poorer physical health and increased health-risk behaviour. A plethora of research has examined the relationship between physical activity and mental wellbeing; however, the influence of community-wide gamification-based physical activity interventions on mental wellbeing, to the authors' knowledge, is yet to be explored. In view of this paucity of attention, the current study examined the relationship between physical activity and mental wellbeing pre/post a community-wide, gamification-based intervention. The findings revealed that increases in mental wellbeing were significantly greater for the least active prior to the intervention, and a strong, positive correlation between increase in physical activity and increase in mental wellbeing was observed.

Examination of the Comorbidity of Mental Illness and Somatic Conditions in Hospitalized Children in the United States Using the Kids' Inpatient Database, 2009.

PubMed

Sztein, Dina M; Lane, Wendy G

2016-03-01

To examine the associations between mental and physical illness in hospitalized children. The data for this analysis came from the 2009 Kids' Inpatient Database (KID). Any child with an International Classification of Diseases, Ninth Revision code indicative of depressive, anxiety, or bipolar disorders or a diagnosis of sickle cell disease, diabetes mellitus type 1 or 2, asthma, or attention-deficit/hyperactivity disorder (ADHD) were included. Using SAS software, we performed χ(2) tests and multivariable logistic regression to determine degrees of association. Children discharged with sickle cell disease, asthma, diabetes mellitus type 1, diabetes mellitus type 2, and ADHD were 0.94, 2.76, 3.50, 6.37, and 38.39 times more likely to have a comorbid anxiety, depression, or bipolar disorder diagnosis than other hospitalized children, respectively. Children with several chronic physical illnesses (asthma, diabetes mellitus type 1, diabetes mellitus type 2) and mental illnesses (ADHD) have higher odds of being discharged from the hospital with a comorbid mood or anxiety disorder compared with other children discharged from the hospital. It is therefore important to screen children hospitalized with chronic medical conditions for comorbid mental illness to ensure optimal clinical care, to improve overall health and long-term outcomes for these children. Copyright © 2016 by the American Academy of Pediatrics.

5 CFR 630.401 - Granting sick leave.

Code of Federal Regulations, 2010 CFR

2010-01-01

... physical or mental illness, injury, pregnancy, or childbirth; (3)(i) Provides care for a family member who is incapacitated by a medical or mental condition or attends to a family member receiving medical...

Activity as a predictor of mental well-being among older adults.

PubMed

Lampinen, P; Heikkinen, R-L; Kauppinen, M; Heikkinen, E

2006-09-01

This eight-year follow-up study examines the roles of physical and leisure activity as predictors of mental well-being among older adults born in 1904-1923. As part of the Evergreen project, 1224 (80%) persons aged 65-84 years were interviewed at baseline (1988), and 663 (90%) persons in the follow-up (1996). Mental well-being factors including depressive symptoms, anxiety, loneliness, self-rated mental vigour and meaning in life were constructed using factor analysis. The predictors of mental well-being included physical and leisure activity, mobility status and number of chronic illnesses. We used a path analysis model to examine the predictors of mental well-being. At baseline, low number of chronic illnesses, better mobility status and leisure activity were associated with mental well-being. Baseline mental well-being, better mobility status and younger age predicted mental well-being in the follow-up. Explanatory power of the path analysis model for the mental well-being factor at baseline was 19% and 35% in the follow-up. These findings suggest that mental well-being in later life is associated with activity, better health and mobility status, which should become targets for preventive measures.

The Feasibility of Using Questionnaires and Accelerometers to Measure Physical Activity and Sedentary Behavior Among Inpatient Adults With Mental Illness.

PubMed

Fraser, Sarah J; Chapman, Justin J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W

2016-05-01

The aim of this study was to assess the feasibility of using questionnaires and accelerometers to measure physical activity and sedentary behavior among inpatient adults with mental illness. Participants completed a physical activity and sitting time questionnaire and wore an accelerometer for 7 consecutive days. Feasibility was assessed in terms of participant engagement, self-reported ease/ difficulty of completing study components, extreme self-report data values and adherence to accelerometer wear time criteria. Ease/difficulty ratings were examined by level of distress. 177 inpatients were invited to the study, 101 completed the questionnaires and 36 provided valid accelerometry data. Participants found it more difficult to complete sitting time and physical activity questionnaires than to wear the accelerometer during waking hours (z = 3.787, P < .001; z = 2.824, P = .005 respectively). No significant differences were found in ease/ difficulty ratings by level of distress for any of the study components. Extreme values for self-reported sitting time were identified in 27% of participants. Inpatient adults with mental illness can engage with self-report and objective methods of measuring physical activity and sedentary behavior. They were initially less willing to participate in objective measurement, which may however be more feasible than self-report measures.

Physical Health, Mental Health, and Substance Abuse Problems of Shelter Users.

ERIC Educational Resources Information Center

Harris, Shirley N.; And Others

1994-01-01

Examined physical health of 72 users of homeless shelters, comparing shelter users with mental illness or substance abuse problems with those without these problems. Found that alcohol abusers were significantly more likely to have low blood pressure, symptoms of liver disease, and tuberculosis treatment history. Found no health differences for…

Family carers' experience of caring for an older parent with severe and persistent mental illness.

PubMed

McCann, Terence V; Bamberg, John; McCann, Flora

2015-06-01

While the burden of caring for older people with chronic medical illness and dementia has been well documented, considerably less is known about how carers develop the strength and resilience to sustain this important role with older family members with mental illness. The aim of the study was to understand the lived experience of primary caregivers of older people with severe and persistent mental illness, and to explore what, if anything, helps to sustain them in their caring role. An interpretative phenomenological analysis approach was adopted, and qualitative interviews were used with 30 primary caregivers. Two overarching themes, and related subthemes, were abstracted from the data. First, caring is a difficult and demanding responsibility. It affects carers adversely, emotionally, physically, socially, and financially, and their lifestyle in general. This is reflected in three subthemes: (i) physically and emotionally draining; (ii) grieving about the loss; (iii) and adverse effects on lifestyle and social relationships. Second, carers develop resilience in caring, which helps sustain them in their role, as illustrated in three subthemes: (i) caring as purposeful and satisfying; (ii) harnessing social support from others; and (iii) purposefully maintaining their own well-being. Community mental health nurses have a key role in assessing carers' needs and supporting them in their caring role. © 2015 Australian College of Mental Health Nurses Inc.

Function in job seekers with mental illness and drug and alcohol problems who access community based disability employment services.

PubMed

Matthews, Lynda R; Harris, Lynne M; Jaworski, Alison; Alam, Ashraful; Bozdag, Gokcen

2013-03-01

This study identified functioning, health, and social needs in jobseekers with mental disorders independently assessed as having capacity to work and referred to disability employment services. Differences in function between jobseekers with mental illness alone and with additional drug and alcohol problems were examined with view to identifying interventions for vocational rehabilitation. A convenience sample of 116 jobseekers completed BASIS-32, CANSAS, AUDIT, DAST-10 and 6 items from the EXIT interview and were divided into two groups: mental illness only, and additional drug and alcohol issues (AUDIT total score >8 and/or DAST total score >3). Analysis of variance was used to determine group differences. Jobseekers reported low-moderate problems with function. Over 40% of the sample reported unresolved psychological distress, physical health needs, and social/daytime activity needs. Thirty-five jobseekers (30%) had additional drug and alcohol problems and reported significantly greater difficulty with impulsive/addictive behavior and poorer memory and executive function than the mental illness only group. No significant differences were identified in past work functioning. Screening all job seekers for psychological, physical, and social needs to identify suitable treatment and rehabilitation strategies and providing interventions that improve emotional regulation and executive function for job seekers with additional drug and alcohol problems may improve employability of job seekers accessing disability employment services.

Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study.

PubMed

Sommer, Jordana L; Mota, Natalie; Edmondson, Donald; El-Gabalawy, Renée

2018-05-10

The current study compared physical and mental health characteristics and quality of life of illness-induced posttraumatic stress disorder (PTSD) versus those with PTSD due to external traumatic events in a population-based sample. PTSD was assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) using DSM-5 criteria in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Participants with past-year PTSD (n = 1779) were categorized into two groups: illness-induced (6.5%) and other trauma-induced PTSD (92.9%) based on index trauma. Group differences in physical health, mental health, and quality of life were estimated using multiple logistic and linear regressions with adjustment for demographics and medical morbidity. Compared to PTSD due to external events, illness-induced PTSD had higher rates of life-threatening illness in the past year. Illness-induced PTSD compared to PTSD due to external events was associated with reduced odds of depressive/bipolar disorders and antisocial personality disorder, but increased odds of cannabis use disorder. The groups did not differ on quality of life after accounting for medical morbidity. Illness-induced PTSD is common among American adults and has a similar impact on quality of life as PTSD due to external events, but may have distinct mental health correlates. Copyright © 2018 Elsevier Inc. All rights reserved.

Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices.

PubMed

Briner, Matthias; Manser, Tanja

2013-02-04

A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general.

Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population.

PubMed

Pang, Shirlene; Liu, Jianlin; Mahesh, Mithila; Chua, Boon Yiang; Shahwan, Shazana; Lee, Siau Pheng; Vaingankar, Janhavi Ajit; Abdin, Edimansyah; Fung, Daniel Shuen Sheng; Chong, Siow Ann; Subramaniam, Mythily

2017-10-16

Stigma against mental illnesses is one of the significant obstacles faced by mental health service users and providers. It can develop at a young age and is also influenced by culture. Youths in Southeast Asian countries are under-represented in mental health research, thus this study aims to explore the dimensions of stigma and social tolerance and examine its correlates in the younger, multiethnic population of Singapore. An online survey collected data with sociodemographic questions, the Attitudes Towards Serious Mental Illness (Adolescent version) Scale, Social Tolerance Scale and an open-text question on words or phrases participants associated with the term 'mental illness'. Principal component analysis and multiple regression models were conducted to investigate the factor structure of the attitudes and social tolerance scales and their sociodemographic correlates. Participants included 940 youths aged 14-18 years old who were residing in Singapore at the time of the survey and were recruited through local schools. About a quarter of the students (22.6%) reported participating in mental health awareness campaigns while nearly half (44.5%) associated pejorative words and phrases with the term mental illness. The Attitudes Towards Serious Mental Illness (Adolescent version) Scale yielded five factors while the Social Tolerance Scale yielded two. Ethnicity, gender and nationality were significantly correlated with factors of both scales. Chinese youths showed higher sense of 'physical threat' and lower 'social tolerance' than those of other ethnicities. Females showed more 'wishful thinking', 'social concern' and 'social responsibility' towards the mentally ill than males. The dimensions of stigma and social tolerance are different in Asian cultures compared with Western cultures. Sociodemographic differences in attitudes towards the mentally ill were found among youths living in Singapore. Misconceptions and negative attitudes towards mental illness are common, demonstrating a clear need for effective stigma reduction campaigns. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevalence and determinants of common mental illness among adult residents of Harari Regional State, Eastern Ethiopia

PubMed Central

Hunduma, Gari; Girma, Mulugeta; Digaffe, Tesfaye; Weldegebreal, Fitsum; Tola, Assefa

2017-01-01

Introduction Common mental disorders include depression, anxiety and somatoform disorders are a public health problem in developed as well as developing countries. It represents a psychiatric morbidity with significant prevalence, affecting all stages of life and cause suffering to the individuals, their family and communities. Despite this fact, little information about the prevalence of common mental illness is available from low and middle-income countries including Ethiopia. The aim of this study was to determine the magnitude of common mental disorders and its associated factors among adult residents of Harari Region. Methods Comparative cross-sectional, quantitative community-based survey was conducted From February 1, 2016 to March 30, 2016 in Harari Regional State using multi-stage sampling technique. A total of 968 residents was selected using two stage sampling technique. Of this 901 were participated in the study. Validated and Pretested Self reported questionnaire (SQR_20) was used to determine the maginitude of common mental disorders. Data was entered and analyzed using Epi-info version 3.5.1 and SPSS-17 for windows statistical packages. Univirate, Bi-variate and multivariate logistic regression analysis with 95% CI was employed in order to infer associations. Results The prevalence of common mental illnesses among adults in our study area was 14.9%. The most common neurotic symptoms in this study were often head ache (23.2%), sleep badly (16%) and poor appetite (13.8%). Substance use like Khat chewing (48.2%), tobacco use (38.2%) and alcohol use (10.5%) was highly prevalent health problem among study participant. In multivariate logistic regression analysis, respondents age between 25-34 years, 35-44 years, 45-54 years and above 55years were 6.4 times (AOR 6.377; 95% CI: 2.280-17.835), 5.9 times (AOR 5.900; 95% CI: 2.243-14.859), 5.6 times (AOR 5.648; 95% CI: 2.200-14.50) and 4.1 times (AOR 4.110; 95% CI: 1.363-12.393) more likely having common mental illnesses than those age between 15-24 years, respectively. The occurrence of common mental illness was twice (AOR: 2.162; 95% CI 1.254-3.728) higher among respondents earn less than the average monthly income than those earn more than average monthly income. The odds of developing common mental illnesses were 6.6 times (AOR 6.653; 95% CI: 1.640-6.992) higher among adults with medically confirmed physical disability than those without physical disability. Similarly, adults who chewed Khat were 2.3 times (AOR 2.305; 95% CI: 1.484-3.579) more likely having common mental illnesses than those who did not chew Khat. Adults with emotional stress were twice (AOR 2.063; 95% CI: 1.176-3.619) higher chance to have common mental illnesses than adults without emotional stress. Conclusion This study had reveals that common mental disorders are major public health problems. Advancing age, low average family monthly income, Khat chewing and emotional stress were independent predictors of common mental illnesses. Whereas sex, place of residence, educational status, marital status, occupation, family size, financial stress, taking alcohol, tobacco use and family history of mental illnesses were not statistically associated with common mental illnesses.

Application of Assessment Tools to Examine Mental Health in Workplaces: Job Stress and Depression.

PubMed

Jeon, Sang Won; Kim, Yong-Ku

2018-06-01

Despite the fact that the lifetime and yearly prevalence rates of mental illness continue rising, such diseases have only been acknowledged as involved in workplace health issue since the 2000s. Additionally, while the number of recognized cases of mental illnesses is rather low compared to their prevalence, they have a high likelihood of causing significant problems, including fatalities. Many workers are terrified of losing their jobs due to mental illness and therefore attempt to hide their mental health problems. For this reason, clinicians involved in occupational and environmental medicine should focus on interviews or screenings to identify such hidden mental health problems. More specifically, it would be helpful to evaluate job stress and depression in workplaces to ensure appropriate preventive actions and thereby reduce the prevalence of mental illness. Job stress not only causes mental illness and dissatisfaction with work, but also can increase the prevalence and morbidity of medical diseases, as well as other physical health problems. Depression is a major contributor to work loss and absence with effects surpassing almost all of the chronic medical disorder. These facts show why measure of job stress and depression should be highlighted in the occupational settings. This article introduces a variety of assessment tools to examine mental health, particularly stress and depression, in workplaces. These tools can be used by clinicians or professionals involved in the mental health, occupational safety, or health service fields for running diagnostics or screening tests.

Mental health service user and staff perspectives on tobacco addiction and smoking cessation: A meta-synthesis of published qualitative studies.

PubMed

Malone, V; Harrison, R; Daker-White, G

2018-05-01

WHAT IS KNOWN ON THE SUBJECT?: There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: A meta-synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice. Studies found staff working in mental health services expressed they did not have the confidence to adequately address smoking cessation for people living with mental illness. People living with mental illness would like support and encouragement support to help them achieve successful smoking cessation. People living with mental illness want support from mental health service staff to increase their confidence in smoking cessation rather than mainstream smoking cessation services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Existing evidence-based interventions for smoking cessation has had limited impact on the smoking rates of people living with mental illness. Research is needed into innovative smoking cessation interventions and the service delivery of these interventions for people living with mental illness. Interventions to support people living with mental illness in smoking cessation could be part of mainstream mental health service delivery. Opportunities for smoking cessation training for mental health service staff could be provided. Introduction People with mental illness are up to three times more likely to smoke and experience greater challenges and less success when trying to quit and therefore have higher risk of smoking-related morbidity and mortality. There is a lack of evidence on successful interventions to reduce the smoking rates in people living with serve mental illness. A meta-synthesis was undertaken to summarize the data from multiple studies to inform the development of future smoking cessation intervention studies. Methods MEDLINE, PsycINFO, Embase and CINAHL were searched in March 2017. A total of 965 titles and abstracts were screened for inclusion with 29 papers reviewed in full and 15 studies that met inclusion criteria. Included studies were assessed for quality using the Critical Appraisal Skills Programme tool. Key data across studies were examined and compared, and a thematic analysis was conducted. Results Analysis and synthesis developed five analytical themes: environmental and social context, living with a mental health illness, health awareness, financial awareness and provision of smoking cessation support. Themes generated the interpretive construct: "Whose role is it anyway?" which highlights tensions between staff perspectives on their role and responsibilities to providing smoking cessation support and support service users would like to receive. Relevance to mental health nursing Routine smoking cessation training for mental health professionals and research on innovative smoking cessation interventions to support people living with mental illness are needed. The Cochrane tobacco group has not found sufficient direct evidence of existing evidence-based interventions that have beneficial effect on smoking in people living with mental illness. With this in mind, mental health professionals should be encouraged to engage in future research into the development of new interventions and consider innovative harm reduction strategies for smoking into their practice, to reduce the morbidity and mortality many people living with mental illness experience from tobacco smoking. © 2018 John Wiley & Sons Ltd.

Childhood abuse and neglect among women outpatients with chronic mental illness.

PubMed

Muenzenmaier, K; Meyer, I; Struening, E; Ferber, J

1993-07-01

The purposes of the study were to determine the prevalence of childhood sexual abuse, physical abuse, and neglect among women outpatients with severe and persistent mental illness; to examine patterns of co-occurrence of the various types of abuse; and to explore the relationships between childhood abuse and adult psychiatric symptomatology. Childhood histories of abuse and data on clinical characteristics of 78 women enrolled in a New York State outpatient clinic were elicited in face-to-face interviews using a structured questionnaire. Sixty-five percent of the women reported histories of some type of abuse or neglect during childhood. Forty-five percent of the sample had been sexually abused, 51 percent had been physically abused, and 22 percent had experienced neglect. Seventy-four percent of the sexually abused women, 70 percent of the physically abused women, and 94 percent of the women who experienced neglect reported at least one additional form of abuse or neglect. Respondents who had been abused in childhood had higher levels of depressive and psychotic symptoms and higher rates of sexual victimization in adulthood than those who had not been abused. Women who experienced neglect as children had higher rates of homelessness in adulthood. Chronic mentally ill women seem to experience higher rates of abuse and more types of abuse than the general population. Clinicians should try to determine whether chronic mentally ill women have histories of abuse and to develop interventions to meet their special needs.

The mixed attitudes of nurse's to caring for people with mental illness in a rural general hospital.

PubMed

Reed, Frances; Fitzgerald, Les

2005-12-01

Mainstreaming of mental health care and the prevalence of mental illness have increased the requirement for care by nurses in the general hospital setting. In rural Australia, mental health services are limited and nurses have less access to support and education. Little is known about how these factors influence attitudes and the care of people with mental illness in rural hospitals. A qualitative descriptive study was used to investigate nurses' attitudes to caring for people with mental illness, the issues that impact on their ability to provide care, and the effect of education, experience, and support. In 2003, 10 nurses from two wards in a rural hospital were interviewed. Participants from one ward had education and support from mental health nurses. Attitudes were found to be inextricably linked to issues that influence nurses' ability to provide care. Dislike was apparent from nurses who suggested it was not their role. Others identified fear, causing avoidance. Conversely, those receiving support and education described increased comfort, with some nurses expressing enthusiasm for mental health care, seeing it as integral to nursing. The priority of physical care, time constraints, environmental unsuitability, rurality, and the lack of skill, knowledge, and mental health services reduced safety and effective care. A limited ability to help was reported, despite support for Mental Health Strategy goals. Positive experience promoted through education and support was required for nurses to improve care and attitudes. Notably, collaboration with mental health nurses was identified as helping nurses overcome fear and increase competence in caring for people with mental illness.

A review of the nutritional challenges experienced by people living with severe mental illness: a role for dietitians in addressing physical health gaps.

PubMed

Teasdale, S B; Samaras, K; Wade, T; Jarman, R; Ward, P B

2017-10-01

People experiencing a severe mental illness (SMI), such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic features, have a 20-year mortality gap compared to the general population. This 'scandal of premature mortality' is primarily driven by preventable cardiometabolic disease, and recent research suggests that the mortality gap is widening. Multidisciplinary mental health teams often include psychiatrists, clinical psychologists, specialist mental health nurses, social workers and occupational therapists, offering a range of pharmacological and nonpharmacological treatments to enhance the recovery of clients who have experienced, or are experiencing a SMI. Until recently, lifestyle and life skills interventions targeting the poor physical health experienced by people living with SMI have not been offered in most routine clinical settings. Furthermore, there are calls to include dietary intervention as mainstream in psychiatry to enhance mental health recovery. With the integration of dietitians being a relatively new approach, it is important to review and assess the literature to inform practice. This review assesses the dietary challenges experienced by people with a SMI and discusses potential strategies for improving mental and physical health. © 2017 The British Dietetic Association Ltd.

28 CFR 549.43 - Involuntary psychiatric treatment and medication.

Code of Federal Regulations, 2010 CFR

2010-07-01

... treatment for the mental illness and less restrictive alternatives (e.g., seclusion or physical restraint... institution mental health division administrator shall appoint a staff representative. Witnesses should be called if they have information relevant to the inmate's mental condition and/or need for medication, and...

Managing physical and mental health conditions: Consumer perspectives on integrated care.

PubMed

Rollins, Angela L; Wright-Berryman, Jennifer; Henry, Nancy H; Quash, Alicia M; Benbow, Kyle; Bonfils, Kelsey A; Hedrick, Heidi; Miller, Alex P; Firmin, Ruthie; Salyers, Michelle P

2017-01-01

Despite the growing trend of integrating primary care and mental health services, little research has documented how consumers with severe mental illnesses manage comorbid conditions or view integrated services. We sought to better understand how consumers perceive and manage both mental and physical health conditions and their views of integrated services. We conducted semi-structured interviews with consumers receiving primary care services integrated in a community mental health setting. Consumers described a range of strategies to deal with physical health conditions and generally viewed mental and physical health conditions as impacting one another. Consumers viewed integration of primary care and mental health services favorably, specifically its convenience, friendliness and knowledge of providers, and collaboration between providers. Although integration was viewed positively, consumers with SMI may need a myriad of strategies and supports to both initiate and sustain lifestyle changes that address common physical health problems.

Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS).

PubMed

Ten Have, Margreet; de Graaf, Ron; Monshouwer, Karin

2011-11-01

To establish associations between physical exercise during leisure time and prevalence, incidence and course of mental disorders. Data were derived from the Netherlands Mental Health Survey and Incidence Study, a 3-wave cohort study in a representative sample (N=7,076) of Dutch adults. Mental disorders were assessed with the Composite International Diagnostic Interview. Physical activity was established by the number of hours per week people spent on taking physical exercise. Physical exercise was negatively associated with presence and first-onset of mood and anxiety disorders after adjustment for confounders. Evidence for a dose-response relationship between exercise levels and mental health was not found. Among those with mental disorder at baseline, exercise participants were more likely to recover from their illness (OR=1.47) compared to their counterparts who did not take exercise. Physical exercise is beneficial to mental health, but it remains uncertain whether this association truly reflects a causal effect of exercise. 2011 Elsevier Inc. All rights reserved.

Liaison psychiatry professionals' views of general hospital care for patients with mental illness: The care of patients with mental illness in the general hospital setting.

PubMed

Noblett, J; Caffrey, A; Deb, T; Khan, A; Lagunes-Cordoba, E; Gale-Grant, O; Henderson, C

2017-04-01

Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'. The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care. Copyright © 2017 Elsevier Inc. All rights reserved.

Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.

PubMed

Jolles, Mónica Pérez; Haynes-Maslow, Lindsey; Roberts, Megan C; Dusetzina, Stacie B

2015-08-01

Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings. Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits). Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (P<0.05). There were no differences in service use by race/ethnicity after controlling for other factors. Additional research is needed on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves toward an integrated care model.

Benefits of Distinguishing between Physical and Social-Verbal Aspects of Behavior: An Example of Generalized Anxiety.

PubMed

Trofimova, Irina; Sulis, William

2016-01-01

Temperament traits and mental illness have been linked to varying degrees of imbalances in neurotransmitter systems of behavior regulation. If a temperament model has been carefully structured to reflect weak imbalances within systems of behavior regulation, then in the presence of mental illness, these profiles should exhibit distinct patterns consistent with symptoms of mental illness. In contrast to other temperament models used in studies of anxiety disorders, the Functional Ensemble of Temperament (FET) model differentiates not only between emotionality traits, but also between traits related to physical, social-verbal and mental aspects of behavior. This paper analyzed the predictions of the FET model, which maps 12 functional aspects of behavior to symptoms of generalized anxiety disorder (GAD) as described in the DSM/ICD. As an example, the paper describes a study of the coupling of sex, age and temperament traits with GAD using the FET framework. The intake records of 116 clients in treatment with confirmed diagnosis of GAD in a private psychological practice were compared using ANOVA against records of 146 healthy clients using their scores on the FET-based questionnaire, in age groups 17-24, 25-45, 46-65. Patients with GAD in all age groups reported significantly lower Social Endurance, Social Tempo, Probabilistic reasoning (but not in physical aspects of behavior) and higher Neuroticism than healthy individuals, however, no effects on the scales of Motor Endurance or Tempo were found. These findings show the benefits of differentiation between motor-physical and social-verbal aspects of behavior in psychological assessment of mental disorders.

Understanding clinician perception of common presentations in South Asians seeking mental health treatment and determining barriers and facilitators to treatment.

PubMed

Rastogi, Pramit; Khushalani, Sunil; Dhawan, Swaran; Goga, Joshana; Hemanth, Naveena; Kosi, Razia; Sharma, Rashmi K; Black, Betty S; Jayaram, Geetha; Rao, Vani

2014-02-01

Little is known about the presentation of mental health symptoms among South Asians living in the US. To explore mental health symptom presentation in South Asians in the US and to identify facilitators and barriers to treatment. Focus group study. Four focus groups were conducted with 7-8 participants in each group. All participants (N = 29) were clinicians who had been involved in the care of South Asian patients with emotional problems and/or mental illness in the US. Qualitative content analysis. Key themes identified included: generational differences in symptom presentation, stress was the most common symptom for younger South Asians (<40 years of age), while major mental illnesses such as severe depression, psychosis and anxiety disorder were the primary symptoms for older South Asians (>40 years of age). Substance abuse and verbal/physical/sexual abuse were not uncommon but were often not reported spontaneously. Stigma and denial of mental illness were identified as major barriers to treatment. Facilitators for treatment included use of a medical model and conducting systematic but patient-centered evaluations. South Asians living in the US present with a variety of mental health symptoms ranging from stress associated with acculturation to major mental illnesses. Facilitating the evaluation and treatment of South Asians with mental illness requires sensitivity to cultural issues and use of creative solutions to overcome barriers to treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

Workplace accommodations for people with mental illness: a scoping review.

PubMed

McDowell, Caitlin; Fossey, Ellie

2015-03-01

Disability discrimination legislation means that employees with a disability or mental illness are legally entitled to reasonable workplace accommodations that enable them to work effectively and safely. This scoping review aims to investigate the types of workplace accommodations provided for people with mental illness, and their costs and benefits. A literature search was conducted using five electronic databases. Peer reviewed research articles published between 1993 and June 2013 were included in this scoping review and their quality was assessed. Opinion papers, reports, and case descriptions were excluded. Nine studies explored workplace accommodations for people with mental illness. The most commonly reported work-related accommodations were flexible scheduling/reduced hours, modified training and supervision, and modified job duties/descriptions. The least common type of accommodation was physical modification to the workplace. For employees with persistent mental illness who were accessing a supported employment agency, the majority of accommodations related to support from the job coach or employment specialist, such as facilitating communication with the employer during hiring or on the job. The quality of the studies varied considerably and the benefits of the accommodations are not yet well documented. There is limited evidence that a larger number of workplace accommodations are associated with longer job tenure. Workplace accommodations appear to be important to support employees with mental illness, but more accessible information about how disability discrimination legislation applies to this population is needed. Future research should address the implementation and effectiveness of mental health-related workplace accommodations.

Counselors and Physicians Providing Mental Health Services: An Integrated Approach

ERIC Educational Resources Information Center

Enochs, Wendy K; Young, Mark; Choate, Robert O.

2006-01-01

The authors argue that there is a clear link between mental and physical health issues. A wellness-based approach to integrated health care, such as the one described in this article, may allow older clients to be empowered to make lifestyle changes that can improve the quality of their lives and reduce physical illness.

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective

PubMed Central

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Background: Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. Aim: The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. Materials and Methods: This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Results: Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as “access to safe drinking water” (χ2 = 8.994, P < 0.02), “served in the same utensils” (χ2 = 13.648, P < 0.00), had adequate food (χ2 = 11.025, P < 0.02), and allowed to use toilet facilities (χ2 = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ2 = 8.233, P < 0.04) and hurt by bad words (χ2 = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ2 = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ2 = 11.848, P < 0.01). Conclusion: There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness. PMID:26124524

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective.

PubMed

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as "access to safe drinking water" (χ(2) = 8.994, P < 0.02), "served in the same utensils" (χ(2) = 13.648, P < 0.00), had adequate food (χ(2) = 11.025, P < 0.02), and allowed to use toilet facilities (χ(2) = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ(2) = 8.233, P < 0.04) and hurt by bad words (χ(2) = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ(2) = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ(2) = 11.848, P < 0.01). There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness.

Nothing left to chance? The impact of locus of control on physical and mental quality of life in terminal cancer patients.

PubMed

Brown, Alaina J; Thaker, Premal H; Sun, Charlotte C; Urbauer, Diana L; Bruera, Eduardo; Bodurka, Diane C; Ramondetta, Lois M

2017-06-01

The purpose of this study is to evaluate if locus of control (LOC) predicts various quality of life (QOL) and mental well-being measures among terminally ill cancer patients at the time of palliative care consult. Multi-site analysis of patients with advanced cancer being seen as new patients in a Palliative and Supportive Care outpatient clinic. Patients completed the following surveys: locus of control (LOC) scale, Functional Assessment of Chronic Illness Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Hospital Anxiety Depression Scale (HADS), and Herth Hope Index (HHI). Regression models were created to examine the effect of LOC upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of age, gender, race, partnership status, education, and months since diagnosis as potential confounders. This study enrolled 100 patients. After adjusting for site, race, and partnership status, higher levels of LOC chance predicted decreased QOL (FACT-G) (p < 0.01). Higher levels of LOC chance also correlated with increased depression and anxiety (p ≤ 0.01) and decreased meaning/peace and faith (p ≤ 0.01). Additionally, higher levels of LOC chance predicted decreased hope (HHI) (p ≤ 0.001). Terminally ill cancer patients with a high LOC chance may be at risk for decreased physical and mental well-being at the end of life. Efforts should be made to identify these patients and design interventions to increase their feeling of control over the situation in order to improve physical and mental well-being at the end of life.

Illness Perception of Patients with Functional Gastrointestinal Disorders.

PubMed

Xiong, Na-Na; Wei, Jing; Ke, Mei-Yun; Hong, Xia; Li, Tao; Zhu, Li-Ming; Sha, Yue; Jiang, Jing; Fischer, Felix

2018-01-01

To investigate the illness perception characteristics of Chinese patients with functional gastrointestinal disorders (FGID), and the mediating role between symptoms, psychopathology, and clinical outcomes. Six illness groups from four outpatient departments of a general hospital in China were recruited, including the FGID patient group. The modified and validated Chinese version of the illness perception questionnaire-revised was utilized, which contained three sections: symptom identity, illness representation, and causes. The 12-item short-form health survey was utilized to reflect the physical and mental health-related quality of life (HRQoL). The Toronto alexithymia scale was used to measure the severity of alexithymia. Additional behavioral outcome about the frequency of doctor visits in the past 12 months was measured. Pathway analyses with multiple-group comparisons were conducted to test the mediating role of illness perception. Overall, 600 patients were recruited. The illness perceptions of FGID patients were characterized as with broad non-gastrointestinal symptoms (6.8 ± 4.2), a negative illness representation (more chronic course, worse consequences, lower personal and treatment control, lower illness coherence, and heavier emotional distress), and high numbers of psychological and culture-specific attributions. Fit indices of the three hypothesized path models (for physical and mental HRQoL and doctor-visit frequency, respectively) supported the mediating role of illness perceptions. For example, the severity of alexithymia and non-gastrointestinal symptoms had significant negative effect on mental quality of life through both direct (standardized effect: -0.085 and -0.233) and indirect (standardized effect: -0.045 and -0.231) influence via subscales of consequences, emotional representation, and psychological and risk factor attributions. Multi-group confirmatory factor analysis showed similar psychometric properties for FGID patients and the other disease group. The management of FGID patients should take into consideration dysfunctional illness perceptions, non-gastrointestinal symptoms, and emotion regulation.

45 CFR 2301.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic...

5 CFR 1636.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic..., cancer, heart disease, diabetes, mental retardation, emotional illness, HIV disease (whether symptomatic...

45 CFR 1803.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and... “physical or mental impairment” includes, but is not limited to, such diseases and conditions as orthopedic..., cancer, heart disease, diabetes, mental retardation, emotional illness, and drug addiction and alcoholism...

43 CFR 17.503 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and... “physical, mental or sensory impairment” includes, but is not limited to, such diseases and conditions as... sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, drug addiction, and...

24 CFR 891.505 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... reservation. Except for intermediate care facilities for the mentally retarded and individuals with related conditions, this term does not include nursing homes, hospitals, intermediate care facilities, or... designed for the physically disabled, developmentally disabled, or chronically mentally ill depending upon...

24 CFR 891.505 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... reservation. Except for intermediate care facilities for the mentally retarded and individuals with related conditions, this term does not include nursing homes, hospitals, intermediate care facilities, or... designed for the physically disabled, developmentally disabled, or chronically mentally ill depending upon...

24 CFR 891.505 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... reservation. Except for intermediate care facilities for the mentally retarded and individuals with related conditions, this term does not include nursing homes, hospitals, intermediate care facilities, or... designed for the physically disabled, developmentally disabled, or chronically mentally ill depending upon...

24 CFR 891.505 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... reservation. Except for intermediate care facilities for the mentally retarded and individuals with related conditions, this term does not include nursing homes, hospitals, intermediate care facilities, or... designed for the physically disabled, developmentally disabled, or chronically mentally ill depending upon...

24 CFR 891.505 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... reservation. Except for intermediate care facilities for the mentally retarded and individuals with related conditions, this term does not include nursing homes, hospitals, intermediate care facilities, or... designed for the physically disabled, developmentally disabled, or chronically mentally ill depending upon...

Caregivers' Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal.

PubMed

Neupane, Dipika; Dhakal, Sarmila; Thapa, Sabita; Bhandari, Parash Mani; Mishra, Shiva Raj

2016-01-01

Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual's and their caregiver's physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers' attitude towards people with mental illness and perceived stigma. We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out. Overall median score for the domains: attitude (score range: 18-90) and perceived stigma (score range: 12-60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (p<0.05), educational status of caregiver (p<0.001), sex of patient (p<0.05) and type of mental illness (p<0.05). Perceived stigma score varied significantly by caregiver's sex (p<0.05), marital status (p<0.001), educational status (p<0.001), occupation (p<0.05), relation with the patient (p<0.005) and use of alternative treatment modalities (p<0.05). Sex of participant, educational status, sex of patient and type of mental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver's relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma.

Caregivers’ Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal

PubMed Central

Neupane, Dipika; Dhakal, Sarmila; Thapa, Sabita; Bhandari, Parash Mani; Mishra, Shiva Raj

2016-01-01

Background Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual’s and their caregiver’s physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers’ attitude towards people with mental illness and perceived stigma. Methods We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out. Results Overall median score for the domains: attitude (score range: 18–90) and perceived stigma (score range: 12–60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (p<0.05), educational status of caregiver (p<0.001), sex of patient (p<0.05) and type of mental illness (p<0.05). Perceived stigma score varied significantly by caregiver’s sex (p<0.05), marital status (p<0.001), educational status (p<0.001), occupation (p<0.05), relation with the patient (p<0.005) and use of alternative treatment modalities (p<0.05). Conclusion Sex of participant, educational status, sex of patient and type of mental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver’s relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma. PMID:27336391

The Influence of Language Form and Conventional Wording on Judgments of Illness

ERIC Educational Resources Information Center

Reynaert, Cristine C.; Gelman, Susan A.

2007-01-01

Prior research indicates that category labels influence category judgments, but little is known regarding the effects for familiar categories with significant social consequences. The present studies address this issue by examining the effect of linguistic form on judgments of illnesses. Both mental and physical illnesses were presented in each of…

10 CFR 55.25 - Incapacitation because of disability or illness.

Code of Federal Regulations, 2010 CFR

2010-01-01

... § 55.25 Incapacitation because of disability or illness. If, during the term of the license, the licensee develops a permanent physical or mental condition that causes the licensee to fail to meet the... 10 Energy 2 2010-01-01 2010-01-01 false Incapacitation because of disability or illness. 55.25...

Informal care-giving and mental ill-health - differential relationships by workload, gender, age and area-remoteness in a UK region.

PubMed

Doebler, Stefanie; Ryan, Assumpta; Shortall, Sally; Maguire, Aideen

2017-05-01

Informal care-giving can be a demanding role which has been shown to impact on physical, psychological and social well-being. Methodological weaknesses including small sample sizes and subjective measures of mental health have led to inconclusive evidence about the relationship between informal care-giving and mental ill-health. This paper reports on a study carried out in a UK region which investigated the relationship between informal care-giving and mental ill-health. The analysis was conducted by linking three data sets, the Northern Ireland Longitudinal Study, the Northern Ireland Enhanced Prescribing Database and the Proximity to Service Index from the Northern Ireland Statistics and Research Agency. Our analysis used both a subjective measure of mental ill-health, i.e. a question asked in the 2011 Census, and an objective measure, whether the respondents had been prescribed antidepressants by a General Practitioner between 2010 and 2012. We applied binary logistic multilevel modelling to these two responses to test whether, and for what sub-groups of the population, informal care-giving was related to mental ill-health. The results showed that informal care-giving per se was not related to mental ill-health, although there was a strong relationship between the intensity of the care-giving role and mental ill-health. Females under 50, who provided over 19 hours of care, were not employed or worked part-time and who provided care in both 2001 and 2011 were at a statistically significantly elevated risk of mental ill-health. Caregivers in remote areas with limited access to shops and services were also at a significantly increased risk as evidenced by prescription rates for antidepressants. With community care policies aimed at supporting people to remain at home, the paper highlights the need for further research in order to target resources appropriately. © 2016 John Wiley & Sons Ltd.

Promoting Mental Health and Preventing Mental Illness in General Practice.

PubMed

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

Stomach and psyche: eating, digestion, and mental illness in the medicine of Philippe Pinel.

PubMed

Williams, Elizabeth A

2010-01-01

In premodern medicine eating and digestion were often linked to psychic disturbance, yet modern "mental medicine" is generally thought to have abandoned this ancient assumption. The work of Philippe Pinel, founder of French psychiatry and advocate of the "moral treatment," has been regarded as indicative of this process, but in fact eating and digestion remained important to Pinel's understanding of the néuroses, the variety of disease within which he classified both mild and severe forms of mental illness. Pinel's theoretical and clinical innovations in regard to maladies that blended mental and gastric distress left an important legacy both to asylum-based psychiatry and to medical generalists working in private settings in the nineteenth century. Today his work remains valuable for its insistence on the inextricability of the "physical and the moral" in psycho-gastric illness.

Mental Health Service Use for Patients with Co-occurring Mental and Physical Chronic Health Care Needs in Primary Care Settings

PubMed Central

Haynes-Maslow, Lindsey; Roberts, Megan C.; Dusetzina, Stacie B.

2016-01-01

Background Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Objectives Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Research Design Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3,000 physicians in office-based settings. Subjects Office visits from 2007–2010 were pooled for adults ages 35–85 with a depression diagnosis at the time of visit (N=3,659 visits). Measures Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Results Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least one physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (p<0.05). There were no differences in service use by race/ethnicity after controlling for other factors. Conclusions Additional research is needed on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves towards an integrated care model. PMID:26147863

The advent of mental health nurses in Australian general practice.

PubMed

Olasoji, Michael; Maude, Phil

2010-01-01

The remarkable progress that has been witnessed in the physical and material wellbeing for most Australians over the 20th century has not been paralleled by gains in the mental and subjective wellbeing of the population. General practice plays a strategic role in Australia's primary health care, which has been recognised as an essential health system that is able to deliver health to the population in a timely and equitable manner (World Health Organisation [WHO], 2008). General Practitioners are unable to provide adequate care to people experiencing a severe mental illness without support from specialist mental health professional such as a mental health nurse in the practice. The mental health nurse incentive program (MHNIP) offers opportunity for mental health nurses to work collaboratively with GPs in primary health care in the delivery of care to people with a severe mental illness.

Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices

PubMed Central

2013-01-01

Background A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. Methods We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. Results The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. Conclusions The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general. PMID:23379842

Military sexual trauma as a determinant in the development of mental and physical illness in male and female veterans.

PubMed

O'Brien, Betsy S; Sher, Leo

2013-01-01

Military Sexual Trauma (MST) is defined as sexual harassment and or sexual assault experienced by a military service member. It is much more widespread and common than reported. It is associated with pre-combat traumatic experiences and pathologic sequelae including mental and medical illness. An electronic search of the major behavioral science databases was conducted to retrieve studies detailing the social, epidemiological and clinical characteristics of MST and its relationship to psychiatric and medical illness. Studies indicate that military sexual trauma is related to an increase in psychiatric pathology, including posttraumatic stress disorder (PTSD), substance abuse and dependence, depression, anxiety, eating disorders and suicidal behavior. MST is also related to an increase in medical illness, primarily pain-related symptoms involving multiple organ systems, including gastrointestinal, neurological, genitourinary and musculoskeletal. MST is associated with an increased prevalence of mental and physical illness. Although there are some gender differences in the reported rates of MST and there may be some variables, such as prior traumatic experiences, that may make an individual more vulnerable to the psychiatric and medical sequela of MST, it is clear that MST is a major healthcare issue that affects both sexes and warrants further attention and an increase in clinical resources devoted to it. Some preventive measures for decreasing the prevalence of MST may include increasing education and legal prosecution of perpetrators in the military, and increasing access to mental health services for individuals who have suffered from MST.

Increasing physical activity in patients with mental illness--A randomized controlled trial.

PubMed

Göhner, Wiebke; Dietsche, Christine; Fuchs, Reinhard

2015-11-01

The objective of the study was to evaluate whether a motivational-volitional intervention program offered in addition to an existing sport program during stationary treatment is capable of establishing a post-stationary increase in physical activity in persons with mental illness. N=112 in-patients were initially randomly assigned to the control group (CG; standard rehabilitation) or intervention group (IG; standard rehabilitation plus intervention). Assessments were conducted at four measurement points. At 6 months follow up, the level of exercise in the IG was 95 min/week higher than in the CG (p=.02). The participants of the IG were able to increase their level of goal intention until 6 months follow up (t2: p=.03; t4: p=.005); levels of self-efficacy of the IG increased during intervention (t2: p=.001). Changes in volitional aspects were significant over time (t1-t3), but not specifically for the IG. The intervention was effective at increasing the level of physical activity in patients with mental illness who were initially minimally active. Our results suggest that it could be of great use to place the emphasis of a physical activity-enhancing intervention on its motivational effect since volitional aspects are already taken into sufficient account in standard rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Institutions, Politics, and Mental Health Parity

PubMed Central

Hernandez, Elaine M.; Uggen, Christopher

2013-01-01

Mental health parity laws require insurers to extend comparable benefits for mental and physical health care. Proponents argue that by placing mental health services alongside physical health services, such laws can help ensure needed treatment and destigmatize mental illness. Opponents counter that such mandates are costly or unnecessary. The authors offer a sociological account of the diffusion and spatial distribution of state mental health parity laws. An event history analysis identifies four factors as especially important: diffusion of law, political ideology, the stability of mental health advocacy organizations and the relative health of state economies. Mental health parity is least likely to be established during times of high state unemployment and under the leadership of conservative state legislatures. PMID:24353902

The Health and Recovery Peer (HARP) Program: A Peer-Led Intervention to Improve Medical Self-Management for Persons with Serious Mental Illness

PubMed Central

Druss, Benjamin G.; Zhao, Liping; von Esenwein, Silke A.; Bona, Joseph R.; Fricks, Larry; Jenkins-Tucker, Sherry; Sterling, Evelina; DiClemente, Ralph; Lorig, Kate

2010-01-01

Objectives Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. Methods The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. Results At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group*time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group*time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. Conclusions This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers. PMID:20185272

Refocusing on physical health: Community psychiatric nurses' perceptions of using enhanced health checks for people with severe mental illness.

PubMed

Bressington, Daniel; Mui, Jolene; Wells, Harvey; Chien, Wai Tong; Lam, Claire; White, Jacquie; Gray, Richard

2016-06-01

In the present qualitative, descriptive study, we explored Hong Kong community psychiatric nurses' (CPN) perceptions of using comprehensive physical health checks for service users diagnosed with severe mental illness (SMI). Research interviews were conducted with a purposive sample of 11 CPN in order to explore their perceptions about the use of the Health Improvement Profile (HIP) over a 1-year period. Interview data were analysed using inductive thematic analysis. The analysis revealed that the majority of CPN appreciated the comprehensive focus on the physical health of their clients and reported positive changes in their clinical practice. Many of them observed an increase in the motivation of their clients to improve their physical health, and also noted observable benefits in service users' well-being. The use of the HIP also helped the CPN identify implementation barriers, and highlighted areas of the tool that required modifications to suit the local cultural and clinical context. To our knowledge, this is the first study conducted in an Asian mental health service that explores nurses' views about using comprehensive health checks for people with SMI. The findings suggest that such approaches are viewed as being acceptable, feasible, and potentially beneficial in the community mental health setting. © 2016 Australian College of Mental Health Nurses Inc.

Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

PubMed

Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

2014-04-12

It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

Predictors of physical activity in persons with mental illness: Testing a social cognitive model.

PubMed

Zechner, Michelle R; Gill, Kenneth J

2016-12-01

This study examined whether the social cognitive theory (SCT) model can be used to explain the variance in physical exercise among persons with serious mental illnesses. A cross-sectional, correlational design was employed. Participants from community mental health centers and supported housing programs (N = 120) completed 9 measures on exercise, social support, self-efficacy, outcome expectations, barriers, and goal-setting. Hierarchical regression tested the relationship between self-report physical activity and SCT determinants while controlling for personal characteristics. The model explained 25% of the variance in exercise. Personal characteristics explained 18% of the variance in physical activity, SCT variables of social support, self-efficacy, outcome expectations, barriers, and goals were entered simultaneously, and they added an r2 change value of .07. Gender (β = -.316, p = .001) and Brief Symptom Inventory Depression subscale (β = -2.08, p < .040) contributed significantly to the prediction of exercise. In a separate stepwise multiple regression, we entered only SCT variables as potential predictors of exercise. Goal-setting was the single significant predictor, F(1, 118) = 13.59, p < .01), r2 = .10. SCT shows promise as an explanatory model of exercise in persons with mental illnesses. Goal-setting practices, self-efficacy, outcome expectations and social support from friends for exercise should be encouraged by psychiatric rehabilitation practitioners. People with more depressive symptoms and women exercise less. More work is needed on theoretical exploration of predictors of exercise. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cardiovascular health promotion and consumers with mental illness in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris

2015-04-01

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.

Stereotypes do not always apply: findings from a survey of the health behaviours of mental health consumers compared with the general population in New Zealand.

PubMed

Wheeler, Amanda J; McKenna, Brian; Madell, Dominic

2013-11-01

Research suggests that people with mental illness frequently have worse physical health than the general population. Our study sought to investigate the health behaviours of mental health consumers in New Zealand, as we hoped that by clearly describing this group more targeted healthcare could be provided. We surveyed 404 adult mental health consumers about their: height and weight, fruit and vegetable intake, exercise activity, smoking, alcohol and drug use. We found that mental health consumers abstained from alcohol more often than those from the general population sample. However, we also found increased obesity, poorer eating habits, less physical activity, and a higher proportion of smokers among mental health consumers. We also found that those who did drink alcohol did so more heavily than drinkers from the general population sample. Finally, there were a number of interesting demographic variations among mental health consumers in terms of their health behaviours. For example, those in the European/Other ethnic group more often consumed an alcoholic drink at least 3 or 4 times a week than those in other ethnic groups, and those in the Pacific group did this less often. Mental health consumers cannot be stereotyped as a single homogeneous group in relation to their health behaviours. Health professionals should strongly encourage engagement from mental health populations to identify their physical health behaviours. Individual differences in health behaviours should not be ignored just because a mental illness is present.

Adults' Explanations for Intimate Partner Violence During Childhood and Associated Effects.

PubMed

Graham-Bermann, Sandra A; Cater, Åsa K; Miller-Graff, Laura E; Howell, Kathryn H

2017-06-01

Exposure to intimate partner violence (IPV) is known to challenge children's optimal development. This study sought to associate participants' beliefs about IPV held during childhood with their adjustment as adults, and to compare their beliefs from childhood to their beliefs in early adulthood. A nationally representative sample of 703 Swedish young adults reported on their past and present beliefs about the causes of their parents' IPV. Standardized measures assessed their mental health (anxiety, depression, and traumatic stress symptoms) and the quality of their relationships as adults. The most common explanations for IPV were that the perpetrator suffered from physical or mental illness, had relationship problems, or was distressed. Participants were less likely to blame themselves for IPV or to believe that the perpetrator was cruel when they were adults, compared to their reports of themselves as children. Women were more likely to attribute mental or physical illness as the cause of the perpetrator's IPV. Childhood beliefs that the perpetrator was debilitated (from mental illness or substance abuse) and cruel (took pleasure in violence and/or despised the child) were associated with greater mental health problems and poorer relationship quality in adulthood. Evaluation of children's harmful beliefs about IPV could be useful in adapting intervention services aimed at ameliorating negative personal causal attributions. © 2016 Wiley Periodicals, Inc.

Comparing mental health literacy and physical health literacy: an exploratory study.

PubMed

Wickstead, Robert; Furnham, Adrian

2017-10-01

This study compared mental health and physical health literacy using five health problems from each area. The aim was to determine whether the same group had better physical than mental health literacy Method: A sample of 263 participants completed an online questionnaire requiring them to name a problem/illness described in 10 vignettes and suggest treatment options. Five vignettes described mental health problems (anxiety, bipolar-disorder, depression, OCPD and schizophrenia) and five physical problems (angina, COPD, diabetes, a heart attack, and sinusitis). Participants were also asked to rate their sympathy and estimates of prevalence for each disorder. Recognition of the mental health disorders was superior compared recognition of the physical disorders. Analysis of treatment beliefs, sympathy and prevalence ratings also showed significant differences between disorders. Results highlight the importance of education and the lack of public knowledge regarding major physical health conditions.

[Violence by and against people with mental illnesses].

PubMed

Steinert, Tilman; Traub, Hans-Joachim

2016-01-01

There is robust evidence for an increased risk of violence through people with psychotic disorders. Until recently this was frequently denied to prevent stigmatization. Alcohol and drug abuse equally increases the risk, while appropriate treatment reduces it drastically. Staff in psychiatric hospitals is exposed to an elevated risk of aggressive assaults. A limited number of severely ill and socially disintegrated patients accounts for these incidents, which are often recurrent. Besides patient characteristics, factors such as ward climate, staffing levels, education and attitudes of staff, and physical environment play a major role in aggressive escalations. On the other hand, mentally ill people, particularly women, are themselves at a higher risk of becoming victims of violent and non-violent crime. This also applies after correction for variables such as social status and living environment. Additionally mentally ill people are confronted with violence in the form of coercive interventions legitimised by the state (involuntary admission, involuntary treatment, freedom-restrictive measures such as seclusion or manual/physical restraint). In contrast to other countries in Central and Western Europe, involuntary outpatient treatment has never been legalized in Germany. Efforts to reduce violence and coercion in psychiatric facilities by evidence-based interventions are widespread nowadays, treatment guidelines are available.

Treating the untreated: applying a community-based, culturally sensitive psychiatric intervention to confined and physically restrained mentally ill individuals in Bali, Indonesia.

PubMed

Suryani, Luh Ketut; Lesmana, Cokorda Bagus Jaya; Tiliopoulos, Niko

2011-11-01

This study identified, mapped and treated the clinical features of mentally ill people, who had been isolated and restrained by family and community members as a result of a functional failure of the traditional medical, hospital-based mental health model currently practiced in Indonesia. A 10-month epidemiological population survey was carried out in Karangasem regency of Bali, Indonesia. A total of 404,591 individuals were clinically interviewed, of which 895 individuals with mental health problems were identified, with 23 satisfying criteria of physical restraint and confinement. Of the latter, twenty were males; age range was 19-69 years, all diagnosed by the researchers with schizophrenia-spectrum disorder (ICD-10 diagnostic criteria). Duration of restraint ranged from 3 months to 30 years (mean = 8.1 years, SD = 8.3 years). Through the application of a holistic intervention model, all patients exhibited a remarkable recovery within 19 months of treatment. We conclude that the development of a community-based, culturally sensitive and respectful mental health model can serve as an optimum promoter of positive mental health outcomes.

Smoking and environmental characteristics of smokers with a mental illness, and associations with quitting behaviour and motivation; a cross sectional study.

PubMed

Metse, Alexandra P; Wiggers, John; Wye, Paula; Moore, Lyndell; Clancy, Richard; Wolfenden, Luke; Freund, Megan; Van Zeist, Tara; Stockings, Emily; Bowman, Jenny A

2016-04-14

Persons with a mental illness are less likely to be successful in attempts to quit smoking. A number of smoking and environmental characteristics have been shown to be related to quitting behaviour and motivation of smokers generally, however have been less studied among smokers with a mental illness. This study aimed to report the prevalence of smoking characteristics and a variety of physical and social environmental characteristics of smokers with a mental illness, and explore their association with quitting behaviour and motivation. A cross-sectional descriptive study was undertaken of 754 smokers admitted to four psychiatric inpatient facilities in Australia. Multivariable logistic regression analyses were undertaken to explore the association between smoking and environmental characteristics and recent quitting behaviour and motivation. Participants were primarily daily smokers (93 %), consumed >10 cigarettes per day (74 %), and highly nicotine dependent (51 %). A third (32 %) lived in a house in which smoking was permitted, and 44 % lived with other smokers. The majority of participants believed that significant others (68-82 %) and health care providers (80-91 %) would be supportive of their quitting smoking. Reflecting previous research, the smoking characteristics examined were variously associated with quitting behaviour and motivation. Additionally, participants not living with other smokers were more likely to have quit for a longer duration (OR 2.02), and those perceiving their psychiatrist to be supportive of a quit attempt were more likely to have had more quit attempts in the past six months (OR 2.83). Modifiable characteristics of the physical and social environment, and of smoking, should be considered in smoking cessation interventions for persons with a mental illness.

24 CFR 91.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... chronically homeless, a person must have been sleeping in a place not meant for human habitation (e.g., living... disorder, serious mental illness, developmental disability, or chronic physical illness or disability... designed for, or ordinarily used as, a regular sleeping accommodation for human beings. Homeless...

10 CFR 4.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment... one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and... Services, and Developmental Disabilities Amendments of 1978, Pub. L. 95-602 (29 U.S.C. 794). Discriminatory...

40 CFR 12.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Stat. 1617); and the Rehabilitation, Comprehensive Services, and Developmental Disabilities Amendments...

Comparison of health-related quality of life among men with different co-existing severe mental disorders in treatment for substance use.

PubMed

Adan, Ana; Marquez-Arrico, Julia E; Gilchrist, Gail

2017-10-23

Patient-perceived health-related quality of life has become an important outcome in health care as an indicator of treatment effectiveness and recovery for patients with substance use disorder. As no study has assessed health-related quality of life among male patients with substance use disorder and co-existing severe mental illness, we compared health-related quality of life among patients with substance use disorder and the following severe mental illness diagnosis in Barcelona, Spain: schizophrenia, bipolar disorder, major depressive disorder, and examined the associations with clinically related variables. Additionally, we compared results for health-related quality of life in patients with substance use disorder and severe mental illness, with Spanish population norms. We assessed 107 substance use disorder male patients using the 36-Item Short Form Health Survey comparing results across three groups with: comorbid schizophrenia (n = 37), comorbid bipolar disorder (n = 34), and comorbid major depressive disorder (n = 36). Multiple analyses of variance were performed to explore health-related quality of life by the type of co-existing SMI and linear regression analyses examined clinical correlates for the 36-Item Short Form Health Survey dimensions for each group. There were differences in Physical Functioning, Vitality and the Physical Composite Scale among groups. Poorer Physical Functioning was observed for patients with comorbid schizophrenia (80.13±3.27) and major depressive disorder (81.97±3.11) compared with comorbid bipolar disorder patients (94.26±1.93). Patients with substance use disorder and schizophrenia presented lower scores in Vitality (41.6±2.80) than those with co-existing bipolar disorder (55.68±3.66) and major depressive disorder (53.63±2.92). Finally, results in the Physical Composite Scale showed lower scores for patients with comorbid schizophrenia (51.06±1.41) and major depressive disorder (51.99±1.87) than for those with bipolar disorder (60.40±2.17). Moreover, all groups had poorer health-related quality of life, especially Social Functioning, Role-Emotional and Mental Health, compared with population norms. Different clinical variables (e.g. medical disease comorbidity, severity of addiction, psychiatric symptomatology, suicide attempts, drug relapses) were related to different health-related quality of life dimensions depending on the co-existing severe mental illness. Among male patients with substance use disorder, co-existing severe mental illness may influence some health-related quality of life dimensions and clinically related variables. Such differences may require tailored therapeutic interventions.

An overview of treatments for obesity in a population with mental illness.

PubMed

Taylor, Valerie H; Stonehocker, Brian; Steele, Margot; Sharma, Arya M

2012-01-01

Obesity is associated with early mortality and has overtaken smoking as the health problem with the greatest impact on quality of life, mortality, and morbidity. Despite public health initiatives and numerous commercial enterprises focusing on weight loss, obesity rates continue to rise. In part, this is because obesity is a multifaceted, complex illness, impacted by numerous social, psychological, and behavioural factors that are unrecognized in most current initiatives. One significant factor associated with obesity is mental illness. While having a psychiatric illness does not make weight gain inevitable, it does often require that additional tools be added to lifestyle recommendations around diet and exercise. The following article reviews the common approaches to obesity management and addresses how these strategies can be implemented in psychiatric care. It is important that health professionals involved in the care of people with a mental illness become familiar with the interventions available to control and treat the obesity epidemic, as this will improve treatment compliance and ultimately lead to improved physical and psychological outcomes.

Hospitalization Risk Before and After Employment Among Adults With Schizophrenia, Bipolar Disorder, or Major Depression.

PubMed

Luciano, Alison; Metcalfe, Justin D; Bond, Gary R; Xie, Haiyi; Miller, Alexander L; Riley, Jarnee; O'Malley, A James; Drake, Robert E

2016-10-01

The influence of employment on subsequent psychiatric hospitalization for people with serious mental illness is unclear. This study examined whether unemployed people with serious mental illness were more or less likely to experience psychiatric hospitalization after gaining employment. A secondary analysis was conducted of data from the Mental Health Treatment Study. Two years of prospective employment and psychiatric hospital outcomes were examined for 2,055 adults with schizophrenia, bipolar disorder, or major depression. The analyses examined associations between employment and psychiatric hospitalization via multilevel regression by using time-lagged modeling. Employment was associated with a lower subsequent three-month risk of psychiatric hospitalization (odds ratio=.65, 95% confidence interval=.50-.84) after the analysis adjusted for baseline characteristics, including previous psychiatric hospitalizations and self-reported physical health. Unemployed outpatients with serious mental illness were less likely to experience psychiatric hospitalization after gaining employment.

Demonstrating Patterns in the Views Of Stakeholders Regarding Ethically-Salient Issues in Clinical Research: A Novel Use of Graphical Models in Empirical Ethics Inquiry.

PubMed

Kim, Jane Paik; Roberts, Laura Weiss

Empirical ethics inquiry works from the notion that stakeholder perspectives are necessary for gauging the ethical acceptability of human studies and assuring that research aligns with societal expectations. Although common, studies involving different populations often entail comparisons of trends that problematize the interpretation of results. Using graphical model selection - a technique aimed at transcending limitations of conventional methods - this report presents data on the ethics of clinical research with two objectives: (1) to display the patterns of views held by ill and healthy individuals in clinical research as a test of the study's original hypothesis and (2) to introduce graphical model selection as a key analytic tool for ethics research. In this IRB-approved, NIH-funded project, data were collected from 60 mentally ill and 43 physically ill clinical research protocol volunteers, 47 healthy protocol-consented participants, and 29 healthy individuals without research protocol experience. Respondents were queried on the ethical acceptability of research involving people with mental and physical illness (i.e., cancer, HIV, depression, schizophrenia, and post-traumatic stress disorder) and non-illness related sources of vulnerability (e.g., age, class, gender, ethnicity). Using a statistical algorithm, we selected graphical models to display interrelationships among responses to questions. Both mentally and physically ill protocol volunteers revealed a high degree of connectivity among ethically-salient perspectives. Healthy participants, irrespective of research protocol experience, revealed patterns of views that were not highly connected. Between ill and healthy protocol participants, the pattern of views is vastly different. Experience with illness was tied to dense connectivity, whereas healthy individuals expressed views with sparse connections. In offering a nuanced perspective on the interrelation of ethically relevant responses, graphical model selection has the potential to bring new insights to the field of ethics.

Palliative psychiatry for severe persistent mental illness as a new approach to psychiatry? Definition, scope, benefits, and risks.

PubMed

Trachsel, Manuel; Irwin, Scott A; Biller-Andorno, Nikola; Hoff, Paul; Riese, Florian

2016-07-22

As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. Based on the WHO definition of palliative care, a, a working definition of palliative psychiatry is proposed. Palliative psychiatry focuses on mental health rather than medical/physical issues. We propose that the beneficiaries of palliative psychiatry are patients with severe persistent mental illness, who are at risk of therapeutic neglect and/or overly aggressive care within current paradigms. These include long-term residential care patients with severe chronic schizophrenia and insufficient quality of life, those with therapy-refractory depressions and repeated suicide attempts, and those with severe long-standing therapy-refractory anorexia nervosa. An explicitly palliative approach within psychiatry has the potential to improve quality of care, person-centredness, outcomes, and autonomy for patients with severe persistent mental illness. The first step towards a palliative psychiatry is to acknowledge those palliative approaches that already exist implicitly in psychiatry. Basic skills for a palliative psychiatry include communication of diagnosis and prognosis, symptom assessment and management, support for advance (mental health) care planning, assessment of caregiver needs, and referral to specialized services. Some of these may already be considered core skills of psychiatrists, but for a truly palliative approach they should be exercised guided by an awareness of the limited functional prognosis and lifespan of patients with severe persistent mental illness.

Sociodemographic and clinical profile of homeless mentally ill inpatients in a north Indian medical university.

PubMed

Tripathi, A; Nischal, A; Dalal, P K; Agarwal, V; Agarwal, M; Trivedi, J K; Gupta, B; Arya, A

2013-10-01

Homeless mentally ill (HMI) persons are a highly vulnerable and socially disadvantaged population, deprived of even the basic minimal human rights. Data on HMI in India is scarce. This retrospective chart review aimed to evaluate socio-demographic, socio-cultural and clinical profile of HMI patients, and to study reasons of homelessness and outcome related variables in these patients. One hundred and forty homeless persons were admitted to the department of psychiatry of a north Indian medical university from February 2005 to July 2011. Of these, one hundred and twenty-seven (90.7%) had psychiatric illness and six had only intellectual disabilities. The majority of HMI persons were illiterate/minimally literate, adult, male, and from low socioeconomic and rural backgrounds. Most of the patients (55.7%) had more than one psychiatric diagnosis. HMI had considerably high rates of co-morbid substance abuse (44.3%), intellectual disabilities (38.6%) and physical problems (75.4%). Most (84.3%) were mentally ill before leaving home and 54.3% left home themselves due to the illness. Most HMI responded to the treatment. After treatment of mental illness, it was possible to reintegrate about 70% of the patients into their families. Families were willing to accept and support them. Untreated/inadequately treated mental illness was the most common reason for homelessness. Easily accessible treatment and rehabilitation facilities at low cost can improve the plight of such patients. Further research in this area is required. Copyright © 2013 Elsevier B.V. All rights reserved.

Effect on Public Policy from Macro to Nano Aspects of the Deadliest Illness of Mankind: Important Role of Physics

NASA Astrophysics Data System (ADS)

Saxena, Arjun

2013-04-01

The effect on public policy of macro to nano aspects of the deadliest Illness known to mankind is given. The focus is on the important role of physics which has been ignored so far to solve its problems. It is now acknowledged that the deadliest illness is actually a group of illnesses which are lumped together as mental illnesses. They are the most widespread and damaging illnesses in the world. Their impact on the entire society globally is huge because they afflict majority of the people irrespective of race, religion, sex, age, education and economic status. In USA alone, the number afflicted according to the official count is about 80 million (out of a total population of 315 million), and it is projected to increase to about 25 to 30% of the population within two decades. A model is given in this paper to address some of the key issues from macro to nano aspects of the deadliest illness. The information given in this paper is scientific though easy to understand. It will help the elected policy makers, public, physicists, neuroscientists, doctors, and care giving personnel world wide. The model explains the missing links in the diagnosis and treatment of mental illnesses. Additional evidence from other recent studies shall also be given.

Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting.

PubMed

Rönngren, Ylva; Björk, Annette; Kristiansen, Lisbeth; Haage, David; Enmarker, Ingela; Audulv, Åsa

2018-02-01

Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting. © 2017 Australian College of Mental Health Nurses Inc.

Promoting Mental Health and Preventing Mental Illness in General Practice

PubMed Central

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

Abstract This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development. PMID:28250821

Exploring the relationship between social class, mental illness stigma and mental health literacy using British national survey data.

PubMed

Holman, Daniel

2015-07-01

The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy has become an increasingly popular way of framing knowledge and understanding of mental health issues. British Social Attitudes survey data present an opportunity to unpack the relationships between these concepts and social class, an important task given continuing mental health inequalities. Regression analyses were undertaken which centred on depression and schizophrenia vignettes, with an asthma vignette used for comparison. The National Statistics Socio-economic Classification, education and income were used as indicators of class. A number of interesting findings emerged. Overall, class variables showed a stronger relationship with mental health literacy than stigma. The relationship was gendered such that women with higher levels of education, especially those with a degree, had the lowest levels of stigma and highest levels of mental health literacy. Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma. Education emerged as the key indicator of class, followed by the National Statistics Socio-economic Classification, with income effects being marginal. These findings have implications for targeting health promotion campaigns and increasing service use in order to reduce mental health inequalities. © The Author(s) 2014.

45 CFR 707.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ON THE BASIS OF DISABILITY IN PROGRAMS OR ACTIVITIES CONDUCTED BY U.S. COMMISSION ON CIVIL RIGHTS... real or personal property. (e) Individual with disabilities means any person who has a physical or... mental retardation, organic brain syndrome, emotional or mental illness, and specific learning...

15 CFR 8c.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment..., speaking, breathing, learning, and working. (3) “Has a record of such an impairment” means has a history of... Stat. 1617); the Rehabilitation, Comprehensive Services, and Developmental Disabilities Amendments of...

Fourth revolution in psychiatry - Addressing comorbidity with chronic physical disorders.

PubMed

Gautam, Shiv

2010-07-01

The moral treatment of mental patients, Electro Convulsive therapy (ECT), and Psychotropic medications constitute the first, second, and third revolution in psychiatry, respectively. Addressing comorbidities of mental illnesses with chronic physical illnesses will be the fourth revolution in psychiatry. Mind and body are inseparable; there is a bidirectional relationship between psyche and soma, each influencing the other. Plausible biochemical explanations are appearing at an astonishing rate. Psychiatric comorbidity with many chronic physical disorders has remained neglected. Such comorbidity with cardiac, respiratory, Gastrointestinal, endocrinal, and neurological disorders, trauma, and other conditions like HIV and so on, needs to be addressed too. Evidence base of prevalence and causal relationship of psychiatric comorbidities in these disorders has been highlighted and strategies to meet the challenge of comorbidity have been indicated.

Fourth revolution in psychiatry – Addressing comorbidity with chronic physical disorders

PubMed Central

Gautam, Shiv

2010-01-01

The moral treatment of mental patients, Electro Convulsive therapy (ECT), and Psychotropic medications constitute the first, second, and third revolution in psychiatry, respectively. Addressing comorbidities of mental illnesses with chronic physical illnesses will be the fourth revolution in psychiatry. Mind and body are inseparable; there is a bidirectional relationship between psyche and soma, each influencing the other. Plausible biochemical explanations are appearing at an astonishing rate. Psychiatric comorbidity with many chronic physical disorders has remained neglected. Such comorbidity with cardiac, respiratory, Gastrointestinal, endocrinal, and neurological disorders, trauma, and other conditions like HIV and so on, needs to be addressed too. Evidence base of prevalence and causal relationship of psychiatric comorbidities in these disorders has been highlighted and strategies to meet the challenge of comorbidity have been indicated. PMID:21180405

38 CFR Appendix B to Subpart E of... - List of Age Distinctions Contained in Statutes and Regulations Governing Federal Financial...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., incurs a disabling illness or injury . . . which results in such child's inability to continue or resume... begin before the person's eighteenth birthday; (2) if the person has a mental or physical handicap, and... attendance age under State law; or (2) his or her 14th birthday and due to physical or mental handicap may...

38 CFR Appendix B to Subpart E of... - List of Age Distinctions Contained in Statutes and Regulations Governing Federal Financial...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., incurs a disabling illness or injury . . . which results in such child's inability to continue or resume... begin before the person's eighteenth birthday; (2) if the person has a mental or physical handicap, and... attendance age under State law; or (2) his or her 14th birthday and due to physical or mental handicap may...

42 CFR 483.114 - Annual review of NF residents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Annual review of NF residents. 483.114 Section 483... Screening and Annual Review of Mentally Ill and Mentally Retarded Individuals § 483.114 Annual review of NF... physical and mental condition, the resident requires— (1) The level of services provided by— (i) A NF; (ii...

Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

PubMed

O'Campo, Patricia; Hwang, Stephen W; Gozdzik, Agnes; Schuler, Andrée; Kaufman-Shriqui, Vered; Poremski, Daniel; Lazgare, Luis Ivan Palma; Distasio, Jino; Belbraouet, Slimane; Addorisio, Sindi

2017-08-01

Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Homeless adults with mental illness (n 2148). Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

Physical health of patients with severe mental illness: an intervention on medium secure forensic unit.

PubMed

Vasudev, Kamini; Thakkar, Pratish B; Mitcheson, Nicola

2012-01-01

Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side-effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year. A physical health monitoring sheet was introduced in all the patients' records on a 15-bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re-audit were compared. At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re-audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status. This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward. There is a need for improved access to physical health care in long-stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients. Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.

Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD).

PubMed

Mewes, Ricarda; Rief, Winfried; Kenn, Klaus; Ried, Jens; Stenzel, Nikola

2016-01-01

Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal's common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status. Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the 'KKG questionnaire for the assessment of control beliefs about illness and health'. Multiple linear regressions were calculated. The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life. Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.

Factors affecting smoking cessation efforts of people with severe mental illness: a qualitative study.

PubMed

Rae, Jennifer; Pettey, Donna; Aubry, Tim; Stol, Jacqueline

2015-01-01

People with severe mental illness are much more likely to smoke than are members of the general population. Smoking cessation interventions that combine counseling and medication have been shown to be moderately effective, but quit rates remain low and little is known about the experiences of people with severe mental illness in smoking cessation interventions. To address this gap in knowledge, we conducted a qualitative study to investigate factors that help or hinder the smoking cessation efforts of people with severe mental illness. We recruited 16 people with severe mental illness who had participated in a clinical trial of two different smoking cessation interventions, one involving nicotine replacement therapy only and the other nicotine replacement therapy combined with motivational interviewing and a peer support group. We conducted open-ended, semi-structured interviews with participants, who ranged in age from 20 to 56 years old, were equally distributed by gender (eight men and eight women), and were predominantly Caucasian (n = 13, 81%). Primary mental illness diagnoses included schizophrenia/schizoaffective disorder (n = 6, 38%), depression (n = 5, 31%), bipolar disorder (n = 4, 25%), and anxiety disorder (n = 1, 6%). At entry into the clinical trial, participants smoked an average of 22.6 cigarettes per day (SD = 13.0). RESULTS indicated that people with mental illness have a diverse range of experiences in the same smoking cessation intervention. Smoking cessation experiences were influenced by factors related to the intervention itself (such as presence of smoking cessation aids, group supports, and emphasis on individual choice and needs), as well as individual factors (such as mental health, physical health, and substance use), and social-environmental factors (such as difficult life events and social relationships). An improved understanding of the smoking cessation experiences of people with severe mental illness can inform the delivery of future smoking cessation interventions for this population. The results of this study suggest the importance of smoking cessation interventions that offer a variety of treatment options, incorporating choice and flexibility, so as to be responsive to the evolving needs and preferences of individual clients.

29 CFR 2205.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

22 CFR 1600.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

36 CFR 909.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

36 CFR 812.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management... AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.160...

Clinic Appointment Attendance in Adults with Serious Mental Illness and Diabetes.

PubMed

Gunzler, Douglas D; Morris, Nathan; Dalton, Jarrod E; McCormick, Richard; Dawson, Neal V; Thomas, Charles; Kanuch, Stephanie; Cassidy, Kristin A; Athey, Melanie; Fuentes-Casiano, Edna; Lawless, Mary Ellen; Martin, Siobhan; Einstadter, Douglas; Sajatovic, Martha

2017-11-01

We assessed characteristics that may predict outpatient appointment attendance in outpatient medical clinics among patients comorbid for serious mental illness (SMI) and type 2 diabetes (DM). Baseline covariate data from 200 individuals with SMI-DM enrolled in a randomized controlled trial (RCT) were used to examine characteristics associated with electronic health record-identified clinic appointment attendance using a generalized estimating equations approach. The analyses evaluated the relationship between clinic attendance and potentially modifiable factors including disease knowledge, self-efficacy, social support, physical health, and mental health, as well as demographic information. Demographic and mental health characteristics were most associated with clinic attendance in adults with SMI-DM. Physical health was not associated with clinic attendance. Information on clinical and demographic characteristics and factors potentially modifiable by psychological interventions may be useful in improving adherence to treatment among SMI-DM patients. It is our hope that clinicians and researchers will use these results to help tailor adherence-facilitating interventions among people at particular risk for poor engagement in care.

Mental health consequences of overstretch in the UK Armed Forces, 2007-09: a population-based cohort study.

PubMed

Rona, Roberto J; Jones, Margaret; Keeling, Mary; Hull, Lisa; Wessely, Simon; Fear, Nicola T

2014-12-01

Concerns have been raised about the effect of tour length on the mental health of the UK armed forces. In 2007, we reported that cumulative length of deployment was associated with mental illness in military personnel. Our findings provided empirical evidence to support the UK advisory policy for tour length, known as the Harmony Guidelines. If fully implemented, these guidelines could aid prevention of mental illnesses. We aimed to reassess the association between cumulative length of deployment and number of deployments with mental illness in the UK forces. Our analysis was based on data from a representative study of the military for UK regular personnel who had completed a questionnaire between Nov 2, 2007, and Sept 24, 2009, and were deployed in the 3 years before questionnaire completion. Study outcomes were presence of possible post-traumatic stress disorder (PTSD), psychological distress, multiple physical symptoms, alcohol misuse, problems at home during and after deployment, and relationship or family problems. The key independent factors were deployment for 13 months or more, and months and number of deployments in the past 3 years. 8278 regulars responded to the questionnaire, of whom 3982 (48%) had been deployed in the 3 years before questionnaire completion. Deployment for 13 months or more decreased from 22% in March, 2005, (median March 8, 2005 [IQR Oct 10, 2004 to April 28, 2005]), to 12% in May, 2008, (May 17, 2008, [Feb 14, 2008, to Dec 5, 2008]). We noted an association between cumulative time deployed as a continuous variable and a score of 40 or more on the PTSD checklist (p=0·002), presence of psychological distress (p=0·018), and multiple physical symptoms (p=0·030; table 2). Furthermore, 13 months or more of deployment was associated with multiple physical symptoms (adjusted odds ratio [OR] 2·15, 95% CI 1·39-3·32), a PTSD checklist score of 40 or more (2·02, 1·31-3·12), and problems at home, but not a PTSD checklist score of 50 or more (1·50, 0·82-2·75), psychological distress 1·34, 0·98-1·85), or alcohol misuse (1·32, 0·97-1·80). Number of deployments was not associated with worse mental illness status or problems at home. The Harmony Guidelines can prevent mental illness in the UK Armed Forces and, since 2006, their introduction has prevented personnel from being deployed for a longer period than recommended in the guidelines. Monitoring of cumulative length of deployment might reduce mental illness in the UK military. The UK Ministry of Defence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Criminal Victimisation in People with Severe Mental Illness: A Multi-Site Prevalence and Incidence Survey in the Netherlands

PubMed Central

Kamperman, Astrid M.; Henrichs, Jens; Bogaerts, Stefan; Lesaffre, Emmanuel M. E. H.; Wierdsma, André I.; Ghauharali, Razia R. R.; Swildens, Wilma; Nijssen, Yolanda; van der Gaag, Mark; Theunissen, Jan R.; Delespaul, Philippe A.; van Weeghel, Jaap; van Busschbach, Jooske T.; Kroon, Hans; Teplin, Linda A.; van de Mheen, Dike; Mulder, Cornelis L.

2014-01-01

Background Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. Method This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227). Results In the past year, almost half of the severely mentally ill outpatients (47%) had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72–2.61), physical assaults (RR = 4.85, 95% CI: 3.69–6.39) and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05–5.09). In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85–14.56). Conclusion Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients’ victimisation risk, and should implement structural measures to detect and prevent (re-)victimisation. PMID:24609108

Extra Physiotherapy in Critical Care (EPICC) Trial Protocol: a randomised controlled trial of intensive versus standard physical rehabilitation therapy in the critically ill.

PubMed

Thomas, Kirsty; Wright, Stephen E; Watson, Gillian; Baker, Catherine; Stafford, Victoria; Wade, Clare; Chadwick, Thomas J; Mansfield, Leigh; Wilkinson, Jennifer; Shen, Jing; Deverill, Mark; Bonner, Stephen; Hugill, Keith; Howard, Philip; Henderson, Andrea; Roy, Alistair; Furneval, Julie; Baudouin, Simon V

2015-05-25

Patients discharged from Critical Care suffer from excessive longer term morbidity and mortality. Physical and mental health measures of quality of life show a marked and immediate fall after admission to Critical Care with some recovery over time. However, physical function is still significantly reduced at 6 months. The National Institute for Health and Care Excellence clinical guideline on rehabilitation after critical illness, identified the need for high-quality randomised controlled trials to determine the most effective rehabilitation strategy for critically ill patients at risk of critical illness-associated physical morbidity. In response to this, we will conduct a randomised controlled trial, comparing physiotherapy aimed at early and intensive patient mobilisation with routine care. We hypothesise that this intervention will improve physical outcomes and the mental health and functional well-being of survivors of critical illness. 308 adult patients who have received more than 48 h of non-invasive or invasive ventilation in Critical Care will be recruited to a patient-randomised, parallel group, controlled trial, comparing two intensities of physiotherapy. Participants will be randomised to receive either standard or intensive physiotherapy for the duration of their Critical Care admission. Outcomes will be recorded on Critical Care discharge, at 3 and 6 months following initial recruitment to the study. The primary outcome measure is physical health at 6 months, as measured by the SF-36 Physical Component Summary. Secondary outcomes include assessment of mental health, activities of daily living, delirium and ventilator-free days. We will also include a health economic analysis. The trial has ethical approval from Newcastle and North Tyneside 2 Research Ethics Committee (11/NE/0206). There is a Trial Oversight Committee including an independent chair. The results of the study will be submitted for publication in peer-reviewed journals and presented at national and international scientific meetings. ISRCTN20436833. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Descriptive Analysis of a Novel Health Care Approach: Reverse Colocation—Primary Care in a Community Mental Health “Home”

PubMed Central

Sirna, Megan; Mangurian, Christina; Dilley, James W.; Shumway, Martha

2013-01-01

Objective: Persons with serious mental illness have increased rates of chronic medical conditions, have limited access to primary care, and incur significant health care expenditures. Few studies have explored providing medical care for these patients in the ambulatory mental health setting. This study describes a real-world population of mental health patients receiving primary care services in a community mental health clinic to better understand how limited primary care resources are being utilized. Method:Chart review was performed on patients receiving colocated primary care (colocation group, N = 143) and randomly chosen patients receiving mental health care only (mental-health group, N = 156) from January 2006 through June 2011. Demographic and mental and physical health variables were assessed. Results: Compared to the mental-health group, the colocation patients had more psychiatric hospitalizations (mean = 1.07 vs 0.23, P < .01), were more likely to be homeless (P < .01), and were more likely to require intensive case management (P < .01). Interestingly, the colocation group was not more medically ill than the mental-health group on key metabolic measures, including mean body mass index (colocation = 27.8 vs mental-health = 28.7, P = .392), low-density liprotein (colocation = 110.0 vs mental-health = 104.4, P = .480), and glucose (colocation = 94.1 vs mental-health = 109.2, P = .059). The most common medical disorders in the colocation group were related to metabolic syndrome. Conclusions: Colocated primary care services were allocated on the basis of severity of psychiatric impairment rather than severity of medical illness. This program serves as a model for other systems to employ for integrated primary and behavioral health services for patients with serious mental illness. PMID:24511447

Maternal Childhood Adversity, Prepregnancy Obesity, and Gestational Weight Gain.

PubMed

Ranchod, Yamini K; Headen, Irene E; Petito, Lucia C; Deardorff, Julianna K; Rehkopf, David H; Abrams, Barbara F

2016-04-01

Growing evidence suggests that exposure to childhood adversity may influence obesity across the life course. High maternal weight complicates pregnancy and increases the risk of child obesity. This study examined the association between maternal childhood adversity and pregnancy-related weight in a large U.S. Data on 6,199 pregnancies from 2,873 women followed from 1979 to 2012 by the National Longitudinal Survey of Youth 1979 were analyzed in 2014. Associations between three adversity exposures before age 18 years (history of physical abuse, alcohol problems, or mental illness in the household) and two maternal weight outcomes (prepregnancy obesity and excessive gestational weight gain) were modeled separately using survey-adjusted log-binomial models. After adjusting for race/ethnicity and early-life socioeconomic factors, childhood physical abuse was associated with a 60% increase in the risk of prepregnancy obesity (adjusted risk ratio=1.6, 95% CI=1.1, 2.2). Household alcohol abuse was associated with a 30% increase in prepregnancy obesity (adjusted risk ratio=1.3, 95% CI=1.0, 1.7), as was household mental illness (adjusted risk ratio=1.3, 95% CI=0.8, 1.9), but the mental illness exposure was not significant. Physical abuse and household alcohol abuse were associated with a significant 20% increase in the risk of excessive gestational weight gain; mental illness was not. Adversity in early life may affect maternal weight before and during pregnancy. Screening and treating women of reproductive age for childhood adversity and its negative effects could significantly reduce obesity-related health outcomes for women and their children. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Perceived human rights violation in persons with mental illness: role of education.

PubMed

Vijayalakshmi, Poreddi; Ramachandra; Reddemma, Konduru; Math, Suresh Bada

2013-06-01

People with mental illness are vulnerable to human rights violations and people with illiteracy and mental illness are at a double disadvantage. To determine the role of education in ascertaining human rights needs of people with mental illness. This was a descriptive study carried out among randomly selected (N = 100) recovered psychiatric patients with mental illness in the past based on the Clinical Global Impression-Improvement scale at a tertiary care centre. Data were collected through face-to-face interview using structured needs assessment questionnaire comprising two sections related to family and community domains. Data were analysed and interpreted using descriptive and inferential statistics. Our findings revealed that human rights needs in the physical needs dimension--i.e., access to electricity (χ2 = 5.523, p < .019) and safe drinking water facilities (χ2 = 9.665, p < .022)--were rated higher in illiterates than in literates. The human rights needs in emotional dimension - i.e. feeling separated from their families because of their illness (χ2 = 13.118, p < .004), afraid of family members (χ2 = 13.388, p < .004) and called filthy nicknames (χ2 = 17.759, p < .000) - were rated higher in literates than in illiterates. The human rights needs in the religious needs dimension - i.e. allowed to go to temple, church, mosque etc. (χ2 = 12.000, p < .007) - and in the social needs dimension - i.e. friendliness with family members -were rated higher in illiterates than in literates (χ2 = 9.661, p < .022). Empowering people with mental illness by providing adequate opportunity to pursue education will play an important role in fulfilling the obligation of the United Nations Convention on the Rights of Persons with Disabilities.

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study.

PubMed

Connaughton, Joanne; Gibson, William

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health-and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry-30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand.

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study

PubMed Central

Gibson, William

2016-01-01

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health—and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry–30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand. PMID:27909364

The first antenatal appointment: An exploratory study of the experiences of women with a diagnosis of mental illness.

PubMed

Phillips, Louise; Thomas, Dona

2015-08-01

to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals. a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes. the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners. twelve participants were selected from one antenatal clinic and one perinatal mental health service. the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services. it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Opportunities in Reform: Bioethics and Mental Health Ethics.

PubMed

Williams, Arthur Robin

2016-05-01

Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. © 2015 John Wiley & Sons Ltd.

OPPORTUNITIES IN REFORM: BIOETHICS AND MENTAL HEALTH ETHICS

PubMed Central

WILLIAMS, ARTHUR ROBINSON

2015-01-01

This year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. Resultantly healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine’s most ethically rich and challenging fields. Bioethics’ distancing from mental illness is perhaps best explained by two overarching themes: 1) an intrinsic opposition between approaches to personhood rooted in Bioethics’ early efforts to protect the competent individual from abuses in the research setting; and 2) structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics’ relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. PMID:26424211

[Psychiatric patients, dialysis, kidney transplant: case report and discussion].

PubMed

Melamed, Yuval; Klein, Osnat; Bzura, Georgina; Finkel, Boris; Bleich, Avi; Bernheim, Jack

2005-05-01

Psychiatric patients' coping capacity with various life situations is limited due to their mental illness. This difficulty is even more pronounced when dealing with severe physical conditions such as kidney failure, the need for dialysis and kidney transplant. In the past, similar to patients who suffered from additional physical conditions, patients with major psychiatric disorders, long-term psychotic illness such as schizophrenia, were not considered candidates for dialysis treatment. Although these attitudes have changed, there is still concern that psychiatric patients would find it difficult to cooperate with the long-term treatment required following kidney transplant, and that lack of careful adherence to medication regimens could lead to rejection of the implant. This article describes five mentally ill individuals who suffer from terminal kidney failure, and illustrates the dilemma associated with dialysis and kidney transplant in psychiatric patients. Close cooperation between the psychiatric staff and the nephrology team can lead to the hoped for outcomes.

Gender-related differences in the human rights needs of patients with mental illness.

PubMed

Vijayalakshmi, Poreddi; Reddemma, Konduru; Math, Suresh Bada

2012-06-01

Individuals with mental illness commonly experience human rights violations while seeking to meet their basic needs. There is lack of research in developing countries on gender-related differences in human rights needs. This study investigated gender differences in perceived human rights needs at the family and community levels in individuals with mental illness in India. This descriptive study surveyed 100 asymptomatic individuals with mental illness at a tertiary care center. Subject selection employed a random sampling method. Data were collected using face-to-face interviews based on a structured needs assessment questionnaire. Data were analyzed and interpreted using descriptive and inferential statistics. Subjects enjoyed a satisfactory level of fulfillment in the physical dimension of human rights needs, which included food, housing, and clothing. Men expressed lower satisfaction than women with perceived human rights needs fulfillment in the emotional dimension. This included fear of family members (χ = 9.419, p < .024) and being called derogatory names (χ = 8.661, p < .034). Women expressed lower satisfaction than men with perceived human rights needs fulfillment in social and ethical dimensions. The former included freedom to leave the home (χ = 11.277, p < .010), and the latter included sexual abuse by family members (χ = 9.491, p < .019). Men felt more discriminated than women due to perceptions of mental illness in the community domain (χ = 10.197, p < .037). This study suggests that family members and communities need to be educated regarding the human rights needs of people with mental illness and that legislation must be strengthened to meet the human rights needs of this disadvantaged population.

Improving the physical health of people with severe mental illness in a low secure forensic unit: An uncontrolled evaluation study of staff training and physical health care plans.

PubMed

Haddad, Mark; Llewellyn-Jones, Sian; Yarnold, Steve; Simpson, Alan

2016-12-01

The life expectancy of people with severe mental illnesses is substantially reduced, and monitoring and screening for physical health problems is a key part of addressing this health inequality. Inpatient admission presents a window of opportunity for this health-care activity. The present study was conducted in a forensic mental health unit in England. A personal physical health plan incorporating clearly-presented and easily-understood values and targets for health status in different domains was developed. Alongside this, a brief physical education session was delivered to health-care staff (n = 63). Printed learning materials and pedometers and paper tape measures were also provided. The impact was evaluated by a single-group pretest post-test design; follow-up measures were 4 months' post-intervention. The feasibility and acceptability of personal health plans and associated resources were examined by free-text questionnaire responses. Fifty-seven staff provided measures of attitudes and knowledge before training and implementation of the physical health plans. Matched-pairs analysis indicated a modest but statistically-significant improvement in staff knowledge scores and attitudes to involvement in physical health care. Qualitative feedback indicated limited uptake of the care plans and perceived need for additional support for better adoption of this initiative. Inpatient admission is a key setting for assessing physical health and promoting improved management of health problems. Staff training and purpose-designed personalized care plans hold potential to improve practice and outcomes in this area, but further support for such innovations appears necessary for their uptake in inpatient mental health settings. © 2016 Australian College of Mental Health Nurses Inc.

Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background Individuals with serious mental illness are at a higher risk of physical ill health. Mortality rates are at least twice those of the general population with higher levels of cardiovascular disease, metabolic disease, diabetes, and respiratory illness. Although genetics may have a role in the physical health problems of these patients, lifestyle and environmental factors such as levels of smoking, obesity, poor diet, and low levels of physical activity also play a prominent part. Methods We conducted a systematic review and meta-analysis of randomised controlled trials comparing the effect of exercise interventions on individuals with serious mental illness. Searches were made in Ovid MEDLINE, Embase, CINAHL, PsycINFO, Biological Abstracts on Ovid, and The Cochrane Library (January 2009, repeated January 2013) through to February 2013. Results Eight RCTs were identified in the systematic search. Six compared exercise versus usual care. One study assessed the effect of a cycling programme versus muscle strengthening and toning exercises. The final study compared the effect of adding specific exercise advice and motivational skills to a simple walking programme. The review found that exercise improved levels of exercise activity (n = 13, standard mean difference [SMD] 1.81, CI 0.44 to 3.18, p = 0.01). No beneficial effect was found on negative (n = 84, SMD = -0.54, CI -1.79 to 0.71, p = 0.40) or positive symptoms of schizophrenia (n = 84, SMD = -1.66, CI -3.78 to 0.45, p = 0.12). No change was found on body mass index compared with usual care (n = 151, SMD = -0.24, CI -0.56 to 0.08, p = 0.14), or body weight (n = 77, SMD = 0.13, CI -0.32 to 0.58, p = 0.57). No beneficial effect was found on anxiety and depressive symptoms (n = 94, SMD = -0.26, CI -0.91 to 0.39, p = 0.43), or quality of life in respect of physical and mental domains. Conclusions This systematic review showed that exercise therapies can lead to a modest increase in levels of exercise activity but overall there was no noticeable change for symptoms of mental health, body mass index, and body weight. PMID:24751159

A School Reentry Program for Chronically Ill Children.

ERIC Educational Resources Information Center

Worchel-Prevatt, Frances F.; Heffer, Robert W.; Prevatt, Bruce C.; Miner, Jennifer; Young-Saleme, Tammi; Horgan, Daniel; Lopez, Molly A.; Frankel, Lawrence; Rae, William A.

1998-01-01

Describes a school reintegration program aimed at overcoming the numerous psychological, physical, environmental, and family-based deterrents to school reentry for chronically ill children. The program uses a systems approach to children's mental health with an emphasis on multiple aspects of the child's environment (i.e., family, medical…

Disability Risks of Chronic Illnesses and Impairments. Disability Statistics Report 2.

ERIC Educational Resources Information Center

LaPlante, Mitchell P.

This report provides results from an investigation of comparative disability risks of specific chronic physical and mental illnesses, diseases, and impairments. National estimates are presented of the risks of chronic health conditions causing disability--including activity limitation, work disability, and need for assistance in basic life…

Consequences of Psychotherapy Clients' Mental Health Ideology.

ERIC Educational Resources Information Center

Milling, Len; Kirsch, Irving

Current theoretical approaches to understanding emotional difficulties are dominated by the medical model of mental illness, which assumes that emotional dysfunction can be viewed the same way as physical dysfunction. To examine the relationship between psychotherapy clients' beliefs about the medical model of psychotherapy and their behavior…

8 CFR 1208.4 - Filing the application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 208.4 - Filing the application.

Code of Federal Regulations, 2012 CFR

2012-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 1208.4 - Filing the application.

Code of Federal Regulations, 2014 CFR

2014-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 208.4 - Filing the application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 208.4 - Filing the application.

Code of Federal Regulations, 2014 CFR

2014-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 1208.4 - Filing the application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 1208.4 - Filing the application.

Code of Federal Regulations, 2012 CFR

2012-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 208.4 - Filing the application.

Code of Federal Regulations, 2013 CFR

2013-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 208.4 - Filing the application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

8 CFR 1208.4 - Filing the application.

Code of Federal Regulations, 2013 CFR

2013-01-01

... illness or mental or physical disability, including any effects of persecution or violent harm suffered in... application, the loss of the spousal or parent-child relationship to the principal applicant through marriage... unaccompanied minor or suffered from a mental impairment) during the 1-year period after arrival; (iii...

49 CFR 807.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

22 CFR 219.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

29 CFR 2706.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

18 CFR 1313.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., emotional or mental illness, and specific learning disabilities. The term “physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of..., Comprehensive Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As...

19 CFR 201.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

45 CFR 1181.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

28 CFR 36.104 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities; (iii) The phrase physical or mental... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION ON THE BASIS OF DISABILITY BY PUBLIC...— Act means the Americans with Disabilities Act of 1990 (Pub. L. 101-336, 104 Stat. 327, 42 U.S.C. 12101...

36 CFR 406.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

16 CFR 1034.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment..., speaking, breathing, learning, and working. (3) Has a record of such an impairment means has a history of... Services, and Developmental Disabilities Amendments of 1978 (Pub. L. 95-602, 92 Stat. 2955). As used in...

HIV serostatus and factors related to physical and mental well-being in Latina family AIDS caregivers.

PubMed

Land, Helen; Hudson, Sharon

2002-01-01

In a survey of 154 Latina AIDS caregivers living in Los Angeles, we examined differences in the stress process for those who were HIV seropositive, seronegative, and those with an unknown serostatus. Most caregivers were monolingual, poor, suffered from chronic physical illness unrelated to HIV, and received few services. All three subsamples reached clinical cut-off levels for depression on the brief symptom inventory. In the sample as a whole and in all three groups we examined differences in primary and secondary stressors as predictors of mental and physical well-being; differences in background factors as they relate to mental and physical well-being; and differences in predictive value of various factors that may attenuate the relationship between stress and mental and physical well-being. Models predicting both mental and physical well-being differ across subsamples divided on the basis of serostatus. Based on these findings, we discuss implications for service provision designed to target these underserved Latina AIDS caregivers.

Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior.

PubMed

Meade, Christina S; Kershaw, Trace S; Hansen, Nathan B; Sikkema, Kathleen J

2009-04-01

The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.

Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services.

PubMed

Chen, Huey Jen

2005-12-01

The stigma of mental illness is one of the factors that prevents Asian Americans/Pacific Islanders (APIs) from seeking formal mental health services. A somatic complaint is more acceptable in expressing psychiatric/emotional distress. Admission diagnoses in API emergency service users with secondary psychiatric diagnoses were identified from the 2001 National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). The sample consisted of 10,623 adult APIs. The study examined the differences in the six leading principal physical admission diagnoses between API emergency service users with psychiatric diagnoses and those without psychiatric diagnoses. Several of the study findings create concern (e.g., the higher percentage of APIs with psychiatric diagnosis who were discharged against medical advice, the high percentage admitted with medication intoxication). Further study is needed to provide guidance for clinical practice.

Photovoice in mental illness research: A review and recommendations

PubMed Central

Han, Christina S; Oliffe, John L

2015-01-01

In the past few decades, photovoice research has gained prominence, providing context rich insights through participants’ photographs and narratives. Emergent within the field of photovoice research have been health studies embracing diverse illness issues. The goal of this scoping review article was to describe the use of photovoice in mental illness, paying particular attention to the following: (1) the study design and methods, (2) empirical findings, and (3) dissemination strategies. Nine qualitative studies (seven drawing from primary and two secondary analyses) featuring diverse approaches to analysis of data comprising individual and/or focus group interviews using participant-produced photographs were included in the review. Described were participant’s experiences of living with mental illness and/or substance overuse, including feelings of loneliness and being marginalized, along with their support care needs (e.g. physical, emotional, and spiritual) to garner self-confidence, respite, and/or recovery. Empirically, the reviewed articles confirmed the value of participant-produced photographs for obtaining in-depth understandings about individual’s mental illness experiences while a focus on stigma and recovery was prominent. In terms of dissemination, while most of the published articles shared some participants’ photographs and narratives, less evident were strategies to actively engage the public or policymakers with the images. Recommendations for future photovoice research include conducting formal analyses of participant photographs and strategically lobbying policymakers and raising public awareness through virtual and “in person” photo exhibitions while de-stigmatizing and affirming the experiences of those who are challenged by mental illness. PMID:25673051

‘Treading water but drowning slowly’: what are GPs’ experiences of living and working with mental illness and distress in England? A qualitative study

PubMed Central

Spiers, Johanna; Chew-Graham, Carolyn A; Taylor, Anna K; Thornton, Gail A; Buszewicz, Marta

2018-01-01

Objectives This paper provides an in-depth account of general practitioners’ (GPs) experiences of living and working with mental illness and distress, as part of a wider study reporting the barriers and facilitators to help-seeking for mental illness and burn-out, and sources of stress/distress for GP participants. Design Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. Setting England. Participants A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face to face or over the telephone. Results The findings report GP participants’ in-depth experiences of distress and mental illness with many recollecting their distressing experiences and significant psychological and physical symptoms relating to chronic stress, anxiety, depression and/or burn-out, and a quarter articulating thoughts of suicide. Many talked about their shame, humiliation and embarrassment at their perceived inability to cope with the stresses of their job and/or their symptoms of mental illness. Conclusions These findings paint a concerning picture of the situation affecting primary care doctors, with participants’ accounts suggesting there is a considerable degree of mental ill health and reduced well-being among GPs. The solutions are complex and lie in prevention and provision. There needs to be greater recognition of the components and cumulative effect of occupational stressors for doctors, such as the increasing workload and the clinical and emotional demands of the job, as well as the need for a culture shift within medicine to more supportive and compassionate work environments. PMID:29724736

Integrated Care to Address the Physical Health Needs of People with Severe Mental Illness: A Mapping Review of the Recent Evidence on Barriers, Facilitators and Evaluations.

PubMed

Rodgers, Mark; Dalton, Jane; Harden, Melissa; Street, Andrew; Parker, Gillian; Eastwood, Alison

2018-01-25

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent reports have looked at ways to better integrate physical and mental health care for people with severe mental illness (SMI). We built on these by conducting a mapping review that looked for the most recent evidence and service models in this area. This involved searching the published literature and speaking to people involved in providing or using current services. Few of the identified service models were described adequately and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge. Efforts to improve the physical health care of people with SMI should empower staff and service users and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.

Two heads are better than one: Australian tobacco control experts' and mental health change champions' consensus on addressing the problem of high smoking rates among people with mental illness.

PubMed

Rowley, Della; Lawn, Sharon; Coveney, John

2016-04-01

Objective The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change champions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness. Methods Qualitative interviews were undertaken to explore participants' views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed. Results This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families. Conclusions Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector. What is known about the topic? Rates of smoking have remained high for people with mental illness despite population-wide public health strategies successfully reducing smoking rates in the general population. For people with mental illness, the benefits of quitting smoking for both their mental and physical health are overshadowed by concerns about the complexity of their needs. There is a lack of knowledge about how smoking cessation support can be improved to increase success rates in smokers with mental illness. What does this paper add? The present study is the first to bring a cross-sector lens of public health and mental health 'experts' together to discuss the reasons for the high rates of smoking among people with mental illness and to obtain their shared agreement on solutions. This Australian-specific study analyses participants' responses to the problem representation and reveals what the issue is considered to be, where action should occur and how the problem should be resolved. What are the implications for practitioners? For the Australian context, there is a need for leadership and a consistent smoke-free message about the benefits of not smoking. Staff working in mental health require training in providing brief interventions, motivational interviewing and pharmacological support. Joining together as a partnership of government and non-government services, including public health leaders and policy makers, and involving people with mental illness and their families, would benefit all concerned.

Relationship Between Care Burden and Religious Beliefs Among Family Caregivers of Mentally Ill Patients.

PubMed

Asadi, Parisa; Fereidooni-Moghadam, Malek; Dashtbozorgi, Bahman; Masoodi, Reza

2018-06-23

Families are considered as primary sources of care for individuals suffering from mental disorders. However, one of the major stresses in families is the infliction of a family member with mental illnesses causing dysfunction in health dimensions or generally their quality of life. Currently, most experts believe that religion can affect physical health and other aspects of human life. So, the aim of this study was to investigate "the relationship between care burden and religious beliefs among family caregivers of mentally ill patients." This cross-sectional study was carried out in Iran on 152 families with mentally ill patients who were hospitalized in psychiatric wards. The sampling method was nonprobability and consecutive sampling method. The data collection instruments included a demographic characteristic questionnaire, Religious Beliefs, and Zarit Care Burden Questionnaires. The mean score for care burden was 30.99 (SD = 16.45). 5.9% of the participants reported a low level, and 39.5% experienced a moderate level of care burden. Moreover, the mean score for religious beliefs was 115.5 (SD = 13.49), and majority of the participants (70.4%) were endowed with strong religious beliefs. There were no significant associations between care burden and intensity of religious beliefs among the study samples (P = 0.483). Considering the results of this study indicating experience of moderate-to-high levels of care burden in families with mentally ill patients, it is recommended to consider such families and their religious beliefs as contributing factors in coping with challenges of mental disorders.

Physical health indicators in major mental illness: data from the Quality and Outcome Framework in the UK.

PubMed

Martin, Julie Langan; Lowrie, Richard; McConnachie, Alex; McLean, Gary; Mair, Frances; Mercer, Stewart; Smith, Daniel

2015-02-26

In the UK, the Quality and Outcome Framework (QOF) has specific targets for general practictioners to record body-mass index (BMI) and blood pressure (BP) in major mental illness, diabetes, and chronic kidney disease. Although incentives are given for aspects of major mental illness (schizophrenia, bipolar disorder, and related psychoses), barriers to care can occur. Our aim was to compare recording of specific targets for BP and BMI in individuals with major mental illness relative to diabetes and chronic kidney disease across the UK. Using 2012 and 2013 QOF data from 9731 general practices across all four countries in the UK, we calculated median payment, population achievement, and exception rates for BP indicators in major mental illness and chronic kidney disease and BMI indicators in major mental illness and diabetes. Differences in unweighted rates between practices in the same UK country were tested with a sign test. Differences in population achievement rate between practices in different countries were compared with those in England by use of a quantile regression analysis. UK payment and population achievement rates for BMI recording in major mental illness were significantly lower than were those in diabetes (payment 92·7% vs 95·5% and population achievement 84·0% vs 92·5%, p<0·0001) and exception rates were higher (8·1% vs 2·0%, p<0·0001). For BP recording, UK payment and population achievement rates were significantly lower for major mental illness than for chronic kidney disease (94·1% vs 97·8% and 87·0% vs 97·1%, p<0·0001), whereas exception rate was higher (6·5% vs 0·0%, p<0·0001). This difference was observed for all UK countries. Median population achievement rates for BMI and BP recording in major mental illness were significantly lower in Scotland than in England (for BMI -1·5%, 99% CI -2·7 to -0·3, and for BP -1·8%, -2·7 to -0·9; p<0·0001 for both). There were no cross-jurisdiction differences for chronic kidney disease and diabetes. We found lower payment rates, higher exception rates, and lower population achievement rates for BMI and BP recording in major mental illness than in diabetes and chronic kidney disease throughout the UK. We also found variation in these rates between countries. This finding is probably multifactorial, reflecting a combination of patient, clinician, and wider organisational factors; however, it might also suggest inequality in access to certain aspects of health care for people with major mental illness. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

Insight and other predictors of physical examination refusal in psychotic illness.

PubMed

Iwata, Kazuya; Strydom, Andre; Osborn, David

2011-08-01

Poor physical health in psychiatric patients is well recognized, yet factors contributing to physical examination noncompliance in psychotic illness have not been previously studied. To examine whether insight or any other variables were independent predictors of physical examination noncompliance. A case-note study (N = 200) of inpatient psychiatric patients in four hospitals in London, UK was conducted to examine the relationship between insight and physical examination noncompliance within 24  h of admission and over 2 weeks. Clinical variables including illness severity were also examined. Patients who were noncompliant with physical examinations offered within 24  h and over 2 weeks were associated with lack of insight, higher illness severity, female gender, longer history of illness, current compulsory admission, and previous history of detention. After adjusting for confounding factors, lack of insight, female gender, and previous history of detention were found to be independent predictors of physical examination noncompliance for 24  h and 2 weeks. Lack of insight is highly predictive of physical examination noncompliance for up to 2 weeks, indicating that mental incapacity to consenting to medical care may be common and that more proactive physical screening may be required for these patients.

Quality of life of mental health consumers in Hong Kong: Analysis of service perceptions.

PubMed

Wu, Crystal F M; Mak, Winnie W S; Wan, Deborah L Y

2007-02-01

Successful psychiatric rehabilitation entails fostering overall quality of life of individuals recovering from severe mental illnesses. Understanding how service-related perceptions may be related to quality of life can be useful in improving the effectiveness of community-based care. This study investigated the quality of life of mental health consumers using a service-oriented paradigm. 162 mental health consumers from community-based psychiatric rehabilitation centers were interviewed. Analyses were conducted to investigate the relationships between service perceptions (perceived treatment coercion, rehabilitation needs, and continuity of care) and quality of life. Physical health quality was negatively related to rehabilitation needs. Mental health quality was negatively related to both rehabilitation needs and poorer continuity of service. Life satisfaction was negatively related to poorer continuity of service and higher perceived treatment coercion. This study highlighted the significance of service perceptions in the well-being of individuals with severe mental illness.

Predictors of Nurse Support for the Introduction of the Cardiometabolic Health Nurse in the Australian Mental Health Sector.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David; Stanton, Robert

2015-07-01

A cardiometabolic specialist nursing role could potentially improve physical health of people with serious mental illness. A national survey of Australian nurses working in mental health settings investigated predictors of support for the role. Predictors included belief in physical healthcare neglect, interest in training; higher perceived value of improving physical health care. The findings suggest that nurses see the cardiometabolic health nurse role as a promising initiative for closing gaps in cardiometabolic health care and skilling other nurses in mental health. However, as the majority of variance in cardiometabolic health nurse support was unexplained, more research is urgently needed on factors that explain differences in cardiometabolic health nurse endorsement. © 2014 Wiley Periodicals, Inc.

Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective

ERIC Educational Resources Information Center

Gatchel, Robert J.

2004-01-01

An exciting period in mental and physical health research is beginning, resulting from a paradigm shift from an outdated biomedical reductionism approach to a more comprehensive biopsychosocial model, which emphasizes the unique interactions among biological, psychological, and social factors required to better understand health and illness. This…

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

14 CFR 382.3 - What do the terms in this rule mean?

Code of Federal Regulations, 2014 CFR

2014-01-01

... devices and medications. Automated airport kiosk means a self-service transaction machine that a carrier... machine means a continuous positive airway pressure machine. Department or DOT means the United States..., emotional or mental illness, and specific learning disabilities. The term physical or mental impairment...

A Study of the Coupling of FET Temperament Traits with Major Depression.

PubMed

Trofimova, Irina N; Sulis, William

2016-01-01

Objective: Temperament and mental illness have been linked to the same systems of behavioral regulation. A temperament model, carefully structured to respond to subtle differences within systems of behavior regulation, should exhibit distinct temperament patterns in the presence of mental illness. Previous comparisons of temperament profiles in mental disorders used mostly emotionality-related traits. In contrast, the Functional Ensemble of Temperament (FET) model differentiates not only between emotionality traits, but also between traits related to physical, verbal, and mental aspects of behavior and maps 12 functional aspects of behavior to temperament traits as well as to symptoms of mental illnesses. This article reports on the coupling of sex, age, and temperament traits with Major Depression (MD) using the FET framework. Method: Intake records of 467 subjects, ages 17-24, 25-45, 46-65, 66-84 were examined, with temperament assessed by the Structure of Temperament Questionnaire (based on the FET). Results: The presence of MD was associated with changes in mean temperament scores on 9 of the 12 traits. The results were in line with the DSM-5 criteria of fatigue (patients with MD reported a significant decrease in three types of endurance - motor-physical, social-verbal, and mental), of psychomotor retardation (a significant decrease in physical and social-verbal tempo) and of worthlessness (as low Self-Confidence). The results also showed that three new symptoms, high Impulsivity, high Neuroticism, and diminished Plasticity, should be considered as depressive symptoms in future versions of the DSM. As a significant negative result, no interaction of age or sex (with the exception of the Self-Confidence scale) with MD was found for temperament traits. Conclusion: The value of differentiating between physical, social, and mental aspects of behavior is demonstrated in the differential effects of major depression and gender. The value of differentiating between endurance, dynamical and orientation-related aspects of behavior is also demonstrated. The deleterious impact of MD on temperament scores appeared to be similar across all age groups. The appearance of high impulsivity, neuroticism, and low plasticity deserve further study as associated factors in future versions of the DSM/ICD.

A Study of the Coupling of FET Temperament Traits with Major Depression

PubMed Central

Trofimova, Irina N.; Sulis, William

2016-01-01

Objective: Temperament and mental illness have been linked to the same systems of behavioral regulation. A temperament model, carefully structured to respond to subtle differences within systems of behavior regulation, should exhibit distinct temperament patterns in the presence of mental illness. Previous comparisons of temperament profiles in mental disorders used mostly emotionality-related traits. In contrast, the Functional Ensemble of Temperament (FET) model differentiates not only between emotionality traits, but also between traits related to physical, verbal, and mental aspects of behavior and maps 12 functional aspects of behavior to temperament traits as well as to symptoms of mental illnesses. This article reports on the coupling of sex, age, and temperament traits with Major Depression (MD) using the FET framework. Method: Intake records of 467 subjects, ages 17–24, 25–45, 46–65, 66–84 were examined, with temperament assessed by the Structure of Temperament Questionnaire (based on the FET). Results: The presence of MD was associated with changes in mean temperament scores on 9 of the 12 traits. The results were in line with the DSM-5 criteria of fatigue (patients with MD reported a significant decrease in three types of endurance – motor-physical, social-verbal, and mental), of psychomotor retardation (a significant decrease in physical and social-verbal tempo) and of worthlessness (as low Self-Confidence). The results also showed that three new symptoms, high Impulsivity, high Neuroticism, and diminished Plasticity, should be considered as depressive symptoms in future versions of the DSM. As a significant negative result, no interaction of age or sex (with the exception of the Self-Confidence scale) with MD was found for temperament traits. Conclusion: The value of differentiating between physical, social, and mental aspects of behavior is demonstrated in the differential effects of major depression and gender. The value of differentiating between endurance, dynamical and orientation-related aspects of behavior is also demonstrated. The deleterious impact of MD on temperament scores appeared to be similar across all age groups. The appearance of high impulsivity, neuroticism, and low plasticity deserve further study as associated factors in future versions of the DSM/ICD. PMID:27933018

What is a mental illness? Public views and their effects on attitudes and disclosure.

PubMed

Rüsch, Nicolas; Evans-Lacko, Sara; Thornicroft, Graham

2012-07-01

'Mental illness' is a common label. However, the general public may or may not consider various conditions, ranging from major psychiatric disorders to stress, as mental illnesses. It is unclear how such public views affect attitudes towards people with mental illness and reactions to one's own potential mental illness, e.g. in terms of help-seeking or disclosure. In representative English population surveys the classification of six conditions (schizophrenia, bipolar disorder, depression, drug addiction, stress, grief) as a mental illness was assessed as well as attitudes towards, and contact with, people with mental illness, intentions to disclose a mental illness and to seek treatment. A factor analysis of how strongly respondents perceived the six conditions as a mental illness yielded two factors: (i) major psychiatric disorders and (ii) stress- and behaviour-related conditions including drug addiction. In regression analyses, higher scores on the first, but not the second, factor predicted less perceived responsibility of people with mental illness for their actions, and more support for a neurobiological illness model and help-seeking. Classifying stress-related/behaviour-related conditions as mental illnesses, as well as not referring to major psychiatric disorders as mental illnesses, was associated with more negative attitudes and increased social distance, but also with stronger intentions to disclose a mental illness to an employer. Negative attitudes and social distance were also related to ethnic minority status and lower social grade. Referring to major psychiatric disorders as mental illnesses may reflect higher mental health literacy, better attitudes towards people with mental illness and help-seeking. A broader concept of mental illness could, although increasing negative attitudes, facilitate disclosure in the workplace. Public views on what is a mental illness may have context-dependent effects and should be taken into account in anti-stigma campaigns.

Examining Perpetration of Physical Violence by Women: The Influence of Childhood Adversity, Victimization, Mental Illness, Substance Abuse, and Anger.

PubMed

Kubiak, Sheryl; Fedock, Gina; Kim, Woo Jong; Bybee, Deborah

2017-02-01

Research on women's perpetration of physical violence has focused primarily on partners, often neglecting perpetration against nonpartners. This study proposes a conceptual model with direct and indirect relationships between childhood adversity and different targets of violence (partners and nonpartners), mediated by victimization experiences (by partner and nonpartners), mental illness, substance abuse, and anger. Using survey data from a random sample of incarcerated women (N = 574), structural equation modeling resulted in significant, albeit different, indirect paths from childhood adversity, through victimization, to perpetration of violence against partners (β = .20) and nonpartners (β = .19). The results indicate that prevention of women's violence requires attention to specific forms of victimization, anger expression, and targets of her aggression.

A Pilot Study of a Peer-Group Lifestyle Intervention Enhanced With mHealth Technology and Social Media for Adults With Serious Mental Illness.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Shevenell, Megan; Kinney, Elizabeth; Bartels, Stephen J

2016-06-01

This pilot study examined the preliminary effectiveness of a peer-group lifestyle intervention enhanced with mobile health technology and social media for obese individuals with serious mental illness. Thirty-two participants with a body mass index of 30 or higher received a 24-week intervention designed to facilitate peer support for lifestyle change through experiential learning and use of wearable activity tracking devices, smartphone applications, and Facebook to reinforce physical activity, healthy eating, and group participation between sessions. The primary outcome was weight loss. Secondary measures included fitness and participants' perceptions of peer-group support. Most participants (72%) lost weight, including 28% achieving clinically significant weight loss, and 17% of participants showed clinically significant improvements in cardiovascular fitness. Weight loss was associated with perceived peer-group support. This evaluation demonstrated the preliminary effectiveness of a potentially scalable peer-group lifestyle intervention delivered in community mental health settings for obese individuals with serious mental illness.

Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care

PubMed Central

DE HERT, MARC; CORRELL, CHRISTOPH U.; BOBES, JULIO; CETKOVICH-BAKMAS, MARCELO; COHEN, DAN; ASAI, ITSUO; DETRAUX, JOHAN; GAUTAM, SHIV; MÖLLER, HANS-JURGEN; NDETEI, DAVID M.; NEWCOMER, JOHN W.; UWAKWE, RICHARD; LEUCHT, STEFAN

2011-01-01

The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 – August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI. PMID:21379357

Cultural Variation in Implicit Mental Illness Stigma.

PubMed

Cheon, Bobby K; Chiao, Joan Y

2012-10-01

Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

Population health management in integrated physical and mental health care.

PubMed

Sieck, Cynthia J; Wickizer, Thomas; Geist, Laurel

2014-01-01

Individuals suffering from serious mental illness (SMI) face many challenges of navigating a complex and often fragmented health care system and may die significantly earlier from co-morbid physical health conditions. Integrating mental and physical health care for individuals with SMI is an emerging trend addressing the often-neglected physical health care needs of this population to better coordinate care and improve health outcomes. Population Health Management (PHM) provides a useful friamework for designing integrated care programs for individuals with SMI. This paper examines the structure and evolution of the integrated care program in Missouri in the context of PHM, highlighting particular elements of PHM that facilitate and support development of an integrated mental and physical health care program. As health care reform provides external motivation to provide integrated care, this study can be useful as other states attempt to address this important issue.

Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans

PubMed Central

Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Gelberg, Lillian

2016-01-01

Purpose: Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless—now housed/case managed through VA Supported Housing (“VASH Veterans”)—and currently homeless. Methods: We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated—adjusting for demographics and need characteristics in regression analyses—between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). Results: On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Conclusion: Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. PMID:27343544

Sleep: a marker of physical and mental health in the elderly.

PubMed

Reid, Kathryn J; Martinovich, Zoran; Finkel, Sanford; Statsinger, Judy; Golden, Robyn; Harter, Kathryne; Zee, Phyllis C

2006-10-01

The objective of this study was to determine the occurrence and recognition of common sleep-related problems and their relationship to health-related quality-of-life measures in the elderly. A total of 1,503 participants with a mean age of 75.5 (+/- 6.8, range: 62-100) years from 11 primary care sites serving primarily elderly patients were interviewed. Subjects completed a five-item sleep questionnaire and the SF-12. A Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) score was calculated. A systematic medical chart review was conducted to determine whether sleep problems were identified by the healthcare providers. A total of 68.9% of patients reported at least one sleep complaint and 40% had two or more. Participants most commonly endorsed (45%) that they had "difficulty falling asleep, staying asleep, or being able to sleep." The number and type of sleep problems endorsed was associated with both physical and mental health quality-of-life status. Excessive daytime sleepiness was the best predictor of poor mental and physical health-related quality of life. Even when all five sleep questions were endorsed, a sleep complaint was only reported in the chart 19.2% of the time. When elicited, sleep complaints predicted the general physical and mental health-related quality-of-life status in elderly populations with comorbid medical and mental illnesses. Yet, questions regarding sleep are not an integral component of most clinical evaluations. Given the growing evidence of a relationship between sleep and health, identification of sleep disorders could lead to improved management of common age-related chronic illnesses and quality of life of elderly patients.

Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review.

PubMed

Larkings, Josephine S; Brown, Patricia M

2018-06-01

Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables. © 2017 Australian College of Mental Health Nurses Inc.

Psychosis, Socioeconomic Disadvantage, and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis

PubMed Central

Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Galletly, Cherrie

2015-01-01

The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper, thus, examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health, and health service utilization in a community sample of 402 participants diagnosed with psychosis. The paper utilizes quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, SA, Australia. Participants (42% female) provided information about socioeconomic status, education, employment, physical health, contact with family and friends, and health service utilization. The paper highlights that socioeconomic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact, and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by this disadvantage be an important focus for mental health services. Such health policy would provide accessible treatment programs and linked pathways to illness recovery and diminish the pressure on the delivery of health services. Consequently, the development of policy and practice that seeks to redress the socioeconomic and health inequalities created by disadvantage should be an important focus for the improvement of mental health services. PMID:26636059

Physical Activity and School Absenteeism Due to Illness in Adolescents.

PubMed

de Groot, Renate; van Dijk, Martin; Savelberg, Hans; van Acker, Frederik; Kirschner, Paul

2017-09-01

Knowledge about the beneficial role of physical activity (PA) for health and school performance is growing. Studies investigating the link between PA and school absenteeism due to illness are lacking. Therefore, we investigated associations between habitual PA and school absenteeism due to illness in adolescents and explored whether mental health and cardiovascular fitness mediated this association. We studied 328 students in grades 7 and 9 (mean age 13.8 years; 49% boys). The PA was measured objectively by an ActivPAL3™ accelerometer attached on the thigh during 1 full week (24 hours/day). Depressive symptoms and self-esteem were self-reported by the Center for Epidemiologic Studies Depression Scale (CES-D) and Rosenberg Self-Esteem Scale, respectively, and included as a proxy for mental health in the analyses. Cardiovascular fitness was measured by the 20-m shuttle-run test. School absenteeism due to illness data was provided by the school administration. The PA was not significantly associated with school absenteeism, though there was an indirect association between PA and school absenteeism by cardiovascular fitness. Cardiovascular fitness mediates the association between PA and school absenteeism due to illness. Thus, cardiovascular fitness of students should be improved to reduce school absenteeism due to illness. © 2017, American School Health Association.

Serious mental illness among young adult women who use drugs in the club scene: co-occurring biopsychosocial factors.

PubMed

Lawental, Maayan; Surratt, Hilary L; Buttram, Mance E; Kurtz, Steven P

2018-01-01

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami's club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a monogamous relationship while 41.9% reported having three or more sexual partners in the past 90 days; 65.3% met DSM-IV criteria for substance dependence; 60.4% met DSM-IV criteria for serious mental illness (SMI) and 59.9% were victimized as minors. Women who had SMI had higher odds of substance dependence, concurrent physical pain, three or more sexual partners in the past 90 days, childhood victimization and severe abuse-related trauma. The high levels of interconnected mental health, victimization, trauma, physical pain, substance dependence and sexual risk factors observed are underreported in the literature, as young women club scene participants appear to be more similar to other marginalized drug-involved populations than previously considered. While further research is needed, it appears these young women are in great need of outreach for primary health, mental health, HIV prevention, increased social support and substance abuse treatment services.

Interwoven histories: Mental health nurses with experience of mental illness, qualitative findings from a mixed methods study.

PubMed

Oates, Jennifer; Drey, Nicholas; Jones, Julia

2018-02-15

The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.

Leisure as a context for active living, recovery, health and life quality for persons with mental illness in a global context

PubMed Central

Iwasaki, Yoshitaka; Coyle, Catherine P.; Shank, John W.

2010-01-01

SUMMARY Globally, the mental health system is being transformed into a strengths-based, recovery-oriented system of care, to which the concept of active living is central. Based on an integrative review of the literature, this paper presents a heuristic conceptual framework of the potential contribution that enjoyable and meaningful leisure experiences can have in active living, recovery, health and life quality among persons with mental illness. This framework is holistic and reflects the humanistic approach to mental illness endorsed by the United Nations and the World Health Organization. It also includes ecological factors such as health care systems and environmental factors as well as cultural influences that can facilitate and/or hamper recovery, active living and health/life quality. Unique to this framework is our conceptualization of active living from a broad-based and meaning-oriented perspective rather than the traditional, narrower conceptualization which focuses on physical activity and exercise. Conceptualizing active living in this manner suggests a unique and culturally sensitive potential for leisure experiences to contribute to recovery, health and life quality. In particular, this paper highlights the potential of leisure engagements as a positive, strengths-based and potentially cost-effective means for helping people better deal with the challenges of living with mental illness. PMID:20543204

Clinical decision making and outcome in routine care for people with severe mental illness (CEDAR): study protocol.

PubMed

Puschner, Bernd; Steffen, Sabine; Slade, Mike; Kaliniecka, Helena; Maj, Mario; Fiorillo, Andrea; Munk-Jørgensen, Povl; Larsen, Jens Ivar; Egerházi, Anikó; Nemes, Zoltan; Rössler, Wulf; Kawohl, Wolfram; Becker, Thomas

2010-11-10

A considerable amount of research has been conducted on clinical decision making (CDM) in short-term physical conditions. However, there is a lack of knowledge on CDM and its outcome in long-term illnesses, especially in care for people with severe mental illness. The study entitled "Clinical decision making and outcome in routine care for people with severe mental illness" (CEDAR) is carried out in six European countries (Denmark, Germany, Hungary, Italy, Switzerland and UK). First, CEDAR establishes a methodology to assess CDM in people with severe mental illness. Specific instruments are developed (and psychometric properties established) to measure CDM style, key elements of CDM in routine care, as well as CDM involvement and satisfaction from patient and therapist perspectives. Second, these instruments are being put to use in a multi-national prospective observational study (bimonthly assessments during a one-year observation period; N = 560). This study investigates the immediate, short- and long-term effect of CDM on crucial dimensions of clinical outcome (symptom level, quality of life, needs) by taking into account significant variables moderating the relationship between CDM and outcome. The results of this study will make possible to delineate quality indicators of CDM, as well as to specify prime areas for further improvement. Ingredients of best practice in CDM in the routine care for people with severe mental illness will be extracted and recommendations formulated. With its explicit focus on the patient role in CDM, CEDAR will also contribute to strengthening the service user perspective. This project will substantially add to improving the practice of CDM in mental health care across Europe. ISRCTN75841675.

Perceived consequences, changeability and personal control of coronary heart disease are associated with health-related quality of life.

PubMed

Sigurdardottir, Arun K; Sigurlásdóttir, Kolbrún; Ólafsson, Kjartan; Svavarsdóttir, Margrét Hrönn

2017-11-01

To explore changes in illness perception and health-related quality of life in patients with coronary heart disease following percutaneous coronary intervention from the time when patients were discharged from hospital and five months later and to investigate association between illness perception and physical and mental health-related quality of life at five-month follow-up. Illness perception is known to influence patients' motivation to engage in preventive behaviour. Prospective and comparative with two measurement points: at discharge from hospital (time 1) and five months later (time 2). Two self-administered questionnaires were used as follows: the Illness Perception Questionnaire-Revised measured illness perception and the Short Form Health Survey (SF-36) measured physical and mental health-related quality of life. The sample consisted of patients with coronary heart disease admitted to University Hospital between November 2011-April 2012. A total of 69 questionnaires were returned for both measurement times. Most responders were male (71%), mean age was 68·9 (SD 10·3) years. Health-related quality of life increased over time, and illness perception changed; five months after discharge, participants were more aware that the disease was chronic and could worsen suddenly, and they perceived that the disease had less of a consequence on their lives compared to when they were staying in the hospital. Associations between increased personal control, changeability of the disease, perceptions of less of a consequence of the disease on daily life and increased health-related quality of life were demonstrated at time 2. Perceptions of personal control, changeability and consequences of the disease should be assessed and discussed with cardiac patients, as these illness perceptions are related to physical and mental health-related quality of life. Increased understanding of consequences of the disease, personal control and perceived changeability of the illness affects health-related quality of life; these are factors that nurses in clinical practice can influence and thereby improve patients' outcomes. © 2017 John Wiley & Sons Ltd.

Spirituality and mental health: a very preliminary overview.

PubMed

Gilbert, Peter Duncan

2007-11-01

Demand for the spiritual dimension to be taken account of in the diagnosis, treatment and care of people with mental ill-health has come strongly from users, carers and professionals. Research in the US over the past 10 years has shown a clear correlation between affiliation to a religious group and better outcomes in terms of mental and physical health, and even longevity. In the UK, however, the evidence from research is much less clear, and needs a more focused approach to really elucidate what helps people stay mentally healthy and recover from mental ill-health. Spirituality is now a key issue as individuals, communities and mental health services struggle to combine technical efficacy and business efficiency, but remain human, so as to nurture service users, carers and staff. This is set in a postmodern world, scarred by the trauma of 9/11 and its aftermaths, and in the context of a global consumerism, which has resulted in individuals being increasingly atomized and isolated. A consumerist society means that those classed as 'deficient consumers', especially those whose ill-health and/or poverty excludes them from the marketplace, are seen as outsiders and a dangerous class.

Coupling of Temperament with Mental Illness in Four Age Groups.

PubMed

Trofimova, Irina; Christiansen, Julie

2016-04-01

Studies of temperament profiles in patients with mental disorders mostly focus on emotionality-related traits, although mental illness symptoms include emotional and nonemotional aspects of behavioral regulation. This study investigates relationships between 12 temperament traits (9 nonemotionality and 3 emotionality related) measured by the Structure of Temperament Questionnaire and four groups of clinical symptoms (depression, anxiety, antisociality, and dominance-mania) measured by the Personality Assessment Inventory. The study further examines age differences in relationships among clinical symptoms and temperament traits. Intake records of 335 outpatients and clients divided into four age groups (18-25, 26-45, 46-65, and 66-85) showed no significant age differences on depression scales; however, the youngest group had significantly higher scores on Anxiety, Antisocial Behavior, Dominance, and Thought Disorders scales. Correlations between Personality Assessment Inventory and Structure of Temperament Questionnaire scales were consistent with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, descriptors showing strong concurrent validity. Several age differences on temperament scales are also reported. Results show the benefits of differentiation between physical, social-verbal, and mental aspects of activities, as well as differentiation between dynamical, orientational, and energetic aspects in studying mental illness and temperament. © The Author(s) 2016.

Assessment of cardiovascular risk in an Italian psychiatric outpatient sample: A chart review of patients treated with second-generation antipsychotics.

PubMed

Severi, Elena; Ferrara, Maria; Tedeschini, Enrico; Vacca, Francesca; Mungai, Francesco; Amendolara, Rocco; Baccari, Flavia; Starace, Fabrizio

2018-06-01

Despite the call by the scientific community for a systematic monitoring of physical health in people with psychiatric illnesses, national and international audits have reported poor quality of cardiovascular risk assessments and management in this vulnerable population. Available evidence indicates that in people affected by mental illness, life expectancy is reduced by 10-20 years, mainly due to cardiovascular accidents and metabolic syndrome (MetS)-related diseases. The primary aim of the present study was to evaluate the accuracy of cardiovascular risk monitoring in an outpatient sample of patients taking second-generation antipsychotics. The sample consisted of 200 patients consecutively recruited from two community mental health centres. A clinical chart review was performed on the following laboratory tests: total cholesterol, high- and low-density lipoprotein, serum triglycerides, fasting blood glucose, γ-glutamyl transpeptidase. Blood pressure and waist circumference were measured. A complete cardiovascular risk assessment was available only in 60 patients out of 200 (33.3%). The only variable associated with laboratory tests for MetS was receiving three or more psychotropic medications, which increased fourfold the probability of metabolic screening. In the subsample of patients with full screening, the prevalence of MetS was 33.3%. Our findings suggest that mental health professionals working in community mental health services should incorporate a more systematic assessment of physical health in their practice, and intervene proactively to reduce the significant cardiovascular burden carried by people with several mental illness. © 2017 Australian College of Mental Health Nurses Inc.

Impact of socio-economic status in meeting the needs of people with mental illness; human rights perspective.

PubMed

Vijayalakshmi, Poreddi; Ramachandra; Reddemma, Konduru; Math, Suresh Bada

2014-04-01

The present descriptive study investigated the impact of socio-economic status in meeting the human rights needs among randomly selected recovered psychiatric patients (n = 100) at a tertiary care center. Data was collected through face to face interview, using structured Needs Assessment Questionnaire. The findings revealed that the participants from below poverty line were deprived of physical needs such as 'electricity facilities' (χ (2) = 6.821, p < .009) 'safe drinking water' (χ (2) = 13.506, p < .004) and purchasing medications (χ (2) = 9.958, p < .019). Conversely, participants from above poverty line were dissatisfied in emotional needs dimension i.e. 'commenting on physical appearance (χ (2) = 8.337, p < .040), afraid of family members (χ (2) = 17.809, p < .000). Thus, there is an urgent need to implement mental illness awareness campaigns and government should take active steps for providing employment, disability pension, free housing, free treatment and free transportation service for people with mental illness to attend hospital or rehabilitation centres.

The PROMIS Global Health Questionnaire Correlates With the QuickDASH in Patients With Upper Extremity Illness.

PubMed

Stoop, Nicky; Menendez, Mariano E; Mellema, Jos J; Ring, David

2018-01-01

The objective of this study is to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health instrument by establishing its correlation to the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in patients with upper extremity illness. A cohort of 112 patients completed a sociodemographic survey and the PROMIS Global Health and QuickDASH questionnaires. Pearson correlation coefficients were used to evaluate the association of the QuickDASH with the PROMIS Global Health items and subscales. Six of the 10 PROMIS Global Health items were associated with the QuickDASH. The PROMIS Global Physical Health subscale showed moderate correlation with QuickDASH and the Mental Health subscale. There was no significant relationship between the PROMIS Global Mental Health subscale and QuickDASH. The consistent finding that general patient-reported outcomes correlate moderately with regional patient-reported outcomes suggests that a small number of relatively nonspecific patient-reported outcome measures might be used to assess a variety of illnesses. In our opinion, the blending of physical and mental health questions in the PROMIS Global Health makes this instrument less useful for research or patient care.

Perceptions of biopsychosocial services needs among older adults with severe mental illness: met and unmet needs.

PubMed

Cummings, Sherry M; Cassie, Kimberly McClure

2008-05-01

This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mental illness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health center to participate in the study. The typical client experienced a need for care in 10 areas, with the greatest needs occurring in the areas of psychological pain, physical illness, social contacts, looking after the home, and daily activities. The total number of unmet needs ranged from zero to 10, with the typical client having an average of 2.3 unmet needs (SD = 2.4). The highest proportions of unmet needs were in the areas of social contact, benefits, sight or hearing difficulties, and intimate relationships. Linear hierarchical regression analyses revealed that clients with lower income, greater impairments in independent daily living skills, and higher levels of depression experienced increased needs for care. Older clients who lived in private homes or apartments had higher levels of depression, and those who required assistance in the areas of intimate relationships and benefits experienced higher levels of unmet needs. Research and practice implications are discussed.

Comorbidities and risk factors among patients with schizophrenia.

PubMed

Harrison, Christopher; Charles, Janice; Britt, Helena

2015-01-01

General practitioners (GPs) are charged with maintaining a holistic approach to their patients' health. While most patients with schizophrenia attend public mental health services and/or non-government organisations supporting people with mental illness, 88.2% of people with a psychotic illness (the majority being schizophrenia or schizoaffective disorder) had visited a GP in the previous year. For at least 30-40% of people living with schizophrenia in Australia, ongoing management is provided by their GP alone. Moreover, there is evidence that patients with schizophrenia value the help provided by GPs. Patients with schizophrenia have reduced life expectancy. Overseas research (primarily from the UK and US) has found that the poor physical health of patients with schizophrenia can be attributed to a number of factors such as modifiable lifestyle risk factors and side effects of medication, compounded by causes intrinsic to the illness such as mental stress and loss of initiative.

14 CFR 1251.102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., organic brain syndrome, emotional or mental illness, and specific learning disabilities. The term physical..., walking, seeing, hearing, speaking, breathing, learning, and working. (iii) Has a record of such an...

Assessing movement quality in persons with severe mental illness - Reliability and validity of the Body Awareness Scale Movement Quality and Experience.

PubMed

Hedlund, Lena; Gyllensten, Amanda Lundvik; Waldegren, Tomas; Hansson, Lars

2016-05-01

Motor disturbances and disturbed self-recognition are common features that affect mobility in persons with schizophrenia spectrum disorder and bipolar disorder. Physiotherapists in Scandinavia assess and treat movement difficulties in persons with severe mental illness. The Body Awareness Scale Movement Quality and Experience (BAS MQ-E) is a new and shortened version of the commonly used Body Awareness Scale-Health (BAS-H). The purpose of this study was to investigate the inter-rater reliability and the concurrent validity of BAS MQ-E in persons with severe mental illness. The concurrent validity was examined by investigating the relationships between neurological soft signs, alexithymia, fatigue, anxiety, and mastery. Sixty-two persons with severe mental illness participated in the study. The results showed a satisfactory inter-rater reliability (n = 53) and a concurrent validity (n = 62) with neurological soft signs, especially cognitive and perceptual based signs. There was also a concurrent validity linked to physical fatigue and aspects of alexithymia. The scores of BAS MQ-E were in general higher for persons with schizophrenia compared to persons with other diagnoses within the schizophrenia spectrum disorders and bipolar disorder. The clinical implications are presented in the discussion.

Community Violence Perpetration and Victimization Among Adults With Mental Illnesses

PubMed Central

Van Dorn, Richard A.; Johnson, Kiersten L.; Grimm, Kevin J.; Douglas, Kevin S.; Swartz, Marvin S.

2014-01-01

Objectives. In a large heterogeneous sample of adults with mental illnesses, we examined the 6-month prevalence and nature of community violence perpetration and victimization, as well as associations between these outcomes. Methods. Baseline data were pooled from 5 studies of adults with mental illnesses from across the United States (n = 4480); the studies took place from 1992 to 2007. The MacArthur Community Violence Screening Instrument was administered to all participants. Results. Prevalence of perpetration ranged from 11.0% to 43.4% across studies, with approximately one quarter (23.9%) of participants reporting violence. Prevalence of victimization was higher overall (30.9%), ranging from 17.0% to 56.6% across studies. Most violence (63.5%) was perpetrated in residential settings. The prevalence of violence-related physical injury was approximately 1 in 10 overall and 1 in 3 for those involved in violent incidents. There were strong associations between perpetration and victimization. Conclusions. Results provided further evidence that adults with mental illnesses experienced violent outcomes at high rates, and that they were more likely to be victims than perpetrators of community violence. There is a critical need for public health interventions designed to reduce violence in this vulnerable population. PMID:24524530

Profile of psychiatric disorders and life events in medically ill elderly: experiences from geriatric clinic in Northern India.

PubMed

Prakash, Om; Gupta, L N; Singh, V B; Singhal, A K; Verma, K K

2007-11-01

Morbidity among elderly people has an important influence on their psychological well-being. Evaluation of the morbidity profile and its determinants, which have implications for management of medical problems of elderly people, are scarce in developing countries. Even the physicians' detection rate of mental distress in elderly populations is low in medical outpatient clinics. This could be due to the large caseloads and also, importantly, underestimation of psychological concerns of the elderly. The objective of this study was to study the psychiatric co-morbidity and life events among elderly medical outpatients. One hundred medically ill elderly (>60 years) patients attending the Geriatric Clinic at Bikaner (North India) constituted the study population. The physical diagnosis was made by a physician based on reported illness, clinical examination and medical records. Psychiatric diagnosis was made by detailed clinical psychiatric interview using ICD-10 guidelines. Life events were assessed by the Indian adaptation of Presumptive Stressful Life Events Scale. Hypertension was the most commonly reported physical diagnosis (50%), other specific medical illnesses were osteoarthritis (15%), diabetes (13%) and constipation (8%). The study found 18% subjects had depression and 11% had other mental disorders. Patients with mental disorders had suffered more recent stressful life events. Among life events, conflicts in family (16%); unemployment of self or children (9%) was reported by elderly psychiatric patients. Other reported life events in psychiatric diagnosed elderly were conflict in family (7%), illness of self (6%) or family members (5%) and death of family members (5%) or close relatives (4%). Mental disorders are common among medically ill elderly patients, but they are poorly recognized and treated. Assessment of the psychiatric morbidity will help in strengthening psycho-geriatric services and thus, improve the quality of life of the elderly. Copyright 2007 John Wiley & Sons, Ltd.

Associations between illness duration and health-related quality of life in specified mental and physical chronic health conditions: results from a population-based survey.

PubMed

Busija, Lucy; Tan, Jeretine; Sanders, Kerrie M

2017-10-01

We compared health-related quality of life (HRQOL) in incident (≤1 year since diagnosis), mid-term (>1-5 years since diagnosis), and long-term (>5 years since diagnosis) cases of mental and physical chronic illness with the general population and assessed the modifying effects of age and gender on the association between HRQOL and illness duration. Data from the 2007 Australian National Health and Mental Wellbeing Survey were used. HRQOL was captured by the Assessment of Quality of Life Scale 4D. Multivariable linear regression analyses compared HRQOL of individuals with different duration of illnesses with those who did not have the condition of interest. The 8841 survey respondents were aged 16-85 years (median 43 years, 50.3% female). For the overall sample, worse HRQOL was associated with incident (P = 0.049) and mid-term (P = 0.036) stroke and long-term depression (P < 0.001) and anxiety (P = 0.001). Age had moderating effect on the associations between HRQOL and duration of asthma (P < 0.001), arthritis (P = 0.001), diabetes (P = 0.004), stroke (P = 0.009), depression (P < 0.001), bipolar disorder (P < 0.001), and anxiety (P < 0.001), but not heart disease (P = 0.102). In older ages, the greatest loss in HRQOL was associated with incident asthma, depression, and bipolar disorder. In younger ages, the greatest loss in HRQOL was associated with arthritis (any duration) and incident diabetes and anxiety. Additionally, gender moderated the association between HRQOL and arthritis, with worse HRQOL among men with incident arthritis (P = 0.047). Loss of HRQOL associated with longer duration of chronic illness is most apparent in stroke and mental illness and differs between age groups.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

PubMed

Patterson, Jo Ellen; Vakili, Susanna

2014-03-01

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.

Primal Alternatives to Talk Therapy: The Batak "Tondi" of North Sumatra.

ERIC Educational Resources Information Center

Pedersen, Paul B.

1993-01-01

Notes that the Toba Batak of North Sumatra provide internalized means of mediating mental health through religious-based notion of the tondi, or source of power, inside the person as the source of mental-physical health and illness. Discusses rituals necessary for maintaining health with rationale supporting those rituals. Describes applications…

Emerging paradigms in medicine: implications for the future of psychiatry.

PubMed

Lake, James

2007-01-01

The causes of mental illness remain obscure in spite of rapid progress in the neurosciences. This is due in part to the fact that contemporary biomedical psychiatry rests on philosophically and scientifically ambiguous ground. In Western medicine paradigms, theories from physics, chemistry, and biology form the basis of an explanatory model of illness, including mental illness. Symptoms are conceptualized as subjective descriptions of effects caused by factors characterized in empirical terms. Conventional biomedicine asserts that all causes of illness, and by extension, mechanisms of action underlying legitimate treatment approaches, rest on biological processes that can be described in the reductionist language of Western science. However, in contemporary Western psychiatry, there is no single adequate explanatory model of the causes of mental illness. What remains are competing psychodynamic, genetic, endocrinologic, and neurobiological models of symptom formation reflecting disparate ideological positions and diverse clinical training backgrounds of mental health professionals. There is no unifying theory in psychiatry because no single explanatory model has been confirmed as more valid than any other. I hypothesize in this article that the synthesis of ideas and clinical approaches from Western biomedicine and non-Western systems of medicine based on understandings of human consciousness, the neurosciences, complexity theory, and quantum field theory, will lead to rapid evolution of conventional Western biomedical psychiatry toward truly integrative mental healthcare. The result will be the emergence of an integrative mental healthcare model that will more adequately address the disparate causes, conditions, and meanings of symptoms combining multimodal approaches from Western biomedicine and non-Western systems of medicine.

Modeling the mental health effects of victimization among homeless persons

PubMed Central

Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

2014-01-01

Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

Modeling the mental health effects of victimization among homeless persons.

PubMed

Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

2008-11-01

Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

Epidemiological study of mental morbidity in an urban slum community in India for the development of a community mental health programme.

PubMed

Silvanus, V; Subramanian, P

2012-03-01

A crossectional field study was carried out in an urban slum in order to assess the prevalence and nature of mental morbidity and identify stressors in the community. A face to face interview was conducted with the help of a questionnaire. The interview consisted of three sections as follows: Data identifying the informant by age, sex, marital status, education, occupation, age at marriage, number of members, children and monthly income. General Health Questionnaire (GHQ) 5- item version used as a screening instrument to assess the present mental health status of the informant and data of past illnesses in self or family and questions framed to elicit perceptions regarding mental illness, alcoholism, their causation and treatment. The subjects who scored above 2 ie 3,4,and 5 in the GHQ were requested to follow up at the Mental Health OPD and subjected to a standardized psychiatric interview by a Psychiatrist. The Diagnostic and Statistical Manual Third Revised (DSM 3 R) criteria were used for diagnosis. After the interview and examination, the appropriate treatment was instituted. A total of 443 individuals were screened. The overall prevalence rate of mental illness in the community was 61 per thousand. It is estimated that the case rate ranges from 38 to 84 per thousand within 95% confidence limits. The overall severity ranged from mild to severe morbidity. The prevalence of severe mental morbidity which includes psychosis, depressive illness, mental retardation was 22.5 per thousand. Neurosis (63.31%) especially Major Depression and Adjustment disorder, Psychosis (10.00%), Somatization disorder (6.66%) and Psychiatric symptoms secondary to physical illness were the major groups of illness. Women were found to have more mental health problems than men. The morbidity pattern also differs significantly with the gender. Neurosis was seen more among the female subjects. There was a significant association of mental health problems with low educational status, unemployment and large family size. Financial problems, marital conflicts, interpersonal conflicts and housing problems were the major stressors as perceived by the respondents. There exists significant mental health problems in the community which can be due to deleterious sociocultural factors and we recommend the integration of mental health care with general health care.

Culturally prescribed beliefs about mental illness among the Akan of Ghana.

PubMed

Opare-Henaku, Annabella; Utsey, Shawn O

2017-08-01

Mental illness is a culturally laden phenomenon, and different cultures have unique ways of constructing mental illness. In this study, conceptions of mental illness were explored among 30 participants of Akan descent in Ghana through individual and group interviews. Participants demonstrated a wide range of knowledge on mental illness indicating that poor self-care, deficits in social functioning, and disordered behaviors are the cardinal features of mental illness. The data revealed that Akan cultural beliefs influenced notions of etiology of mental illness and care of the mentally ill. While participants recognized the role of multiple factors such as genetics, substance abuse, daily hassles (for example, concerns about basic needs such as food, clothing, and shelter), and trauma in the cause of mental illness, the predominant belief was that mental illness is a retributive and/or a spiritual illness. This belief encourages pluralistic health-seeking behaviors: use of hospitals, prayer camps, herbalists, and traditional healers. The implications of these findings for public health education on mental illness, and clinical training and practice are discussed.

Does informed consent given by healthy individuals when enrolling in clinical research feel less voluntary than for ill individuals?

PubMed

Roberts, Laura; Kim, Jane Paik

2018-04-30

Clinical research is predicated ethically on the authentic voluntarism of individuals who choose to enroll in human studies. Existing literature has focused on aspects of informed consent for clinical research other than voluntarism. The objective of this study was to compare the perspectives of clinical research participants who are in good health and who are ill regarding voluntarism-related aspects of informed consent and to assess situational influences that enable voluntarism in the process of obtaining clinical research consent. A 23-item written survey, the Informed Consent Questionnaire (ICQ), was administered in a "piggyback" semi-structured interview study of ill and healthy volunteers enrolled in IRB-approved clinical research studies. A total of 150 (60 mentally ill, 43 physically ill, and 47 healthy) clinical research participants participated. Respondents expressed positive views of their experiences with the informed consent processes for their respective clinical research protocols and respondents strongly endorsed items related to voluntarism irrespective of their illness type (range of means = [3.9, 4.8]). Ill participants more highly endorsed items relating to informed consent conditions (mentally ill vs healthy: 0.54 on a 5-point scale, P value = 0.01) (physically ill vs. healthy: 0.47 on a 5-point scale, P value = 0.01). The favorable views of clinical research participants regarding their experience of giving informed consent to enroll in a study were not surprising. Contrary to our a priori hypothesis, healthy individuals did not feel as positively as their ill counterparts. Copyright © 2018 Elsevier Ltd. All rights reserved.

The changing face of newspaper representations of the mentally ill.

PubMed

Murphy, Neil A; Fatoye, Francis; Wibberley, Christopher

2013-06-01

Negative stereotypes presented in the media may contribute to the stigma associated with mental illness. People's attitudes towards the mentally ill are initially influenced and subsequently maintained in part by the frequent media presentation of negative stereotypes of mental illness. This could result in social rejection of individuals with mental illnesses. To explore how four main U.K. national newspapers reported on mental health/mental illness stories over a 10-year period. This study utilised content analysis to identify words, themes and trends of representation related to the mentally ill in articles from the four newspapers. The findings indicated that there was an increase in the number of articles related to mental health/illness over the time of the study. The rate of increase was far greater than that for the increase in the total number of articles carried in the press over this time period. It was also identified that pejorative terms were used, in a number of the articles, to describe the mentally ill person. Many of the newspaper reports highlighted the need for protection of the general public from the mentally ill, and that the mentally ill were in some way different to the general public. In particular, both the words "violence" and "drugs" were linked to mental health/mental illness in these articles.

Brief Report: Examining the Association of Autism and Adverse Childhood Experiences in the National Survey of Children's Health: The Important Role of Income and Co-Occurring Mental Health Conditions

ERIC Educational Resources Information Center

Kerns, Connor Morrow; Newschaffer, Craig J.; Berkowitz, Steven; Lee, Brian K.

2017-01-01

Adverse childhood experiences (ACEs) are risk factors for mental and physical illness and more likely to occur for children with autism spectrum disorder (ASD). The present study aimed to clarify the contribution of poverty, intellectual disability and mental health conditions to this disparity. Data on child and family characteristics, mental…

[Human rights violations among people with mental illness; rural vs. urban comparison].

PubMed

Poreddi, Vijayalakshmi; Ramachandra; Nagarajaiah; Konduru, Reddemma; Badamath, Suresh

2013-01-01

Human rights violations are commonly reported against people with mental illness and have remained a major research issue in recent times. The present study was aimed to compare psychiatric patients' perceptions of human rights needs between rural and urban settings. A descriptive study design was carried out among 100 recovered psychiatric patients based on the Clinical Global Impression-Improvement Scale (CGI-I scale), at a tertiary care center. Participants were selected through a random sampling method. Data was collected through face to face interviews, using a structured questionnaire. Data was analyzed and interpreted using descriptive and inferential statistics. The present study highlighted the significant differences in meeting their basic human rights needs in a physical needs dimension i.e. availability of hot water for bathing (c2=8.305, p<0.40) and provision of clean clothes to wear (c2=8.229, p<0.42) were rated higher in rural participants than participants from those in an urban setting. Similarly, in the ethical needs dimension, merely 13% of the rural participants reported that they never/rarely experienced sexual advances by family members (c2=9.949, p> .019). Our findings revealed that human rights violations among mentally ill are evident across rural and urban environments. Thus, there is an urgent need to change the attitude of the general population towards people with mental illness through awareness campaign. In addition, educating the public about the human rights of mentally ill is also essential.

The health and wellbeing of Australian farmers: a longitudinal cohort study.

PubMed

Brew, Bronwyn; Inder, Kerry; Allen, Joanne; Thomas, Matthew; Kelly, Brian

2016-09-15

Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. Farmers who lived remotely reported worse mental health (β -0.33, 95 % CI -0.53, -0.13) and wellbeing (β -0.21(95 % CI -0.35, -0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported.

Integrated Care to Address the Physical Health Needs of People with Severe Mental Illness: A Mapping Review of the Recent Evidence on Barriers, Facilitators and Evaluations

PubMed Central

Dalton, Jane; Harden, Melissa; Street, Andrew; Parker, Gillian; Eastwood, Alison

2018-01-01

People with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests this is due to a combination of clinical risk factors, socioeconomic factors, and health system factors, notably a lack of integration when care is required across service settings. Several recent reports have looked at ways to better integrate physical and mental health care for people with severe mental illness (SMI). We built on these by conducting a mapping review that looked for the most recent evidence and service models in this area. This involved searching the published literature and speaking to people involved in providing or using current services. Few of the identified service models were described adequately and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge. Efforts to improve the physical health care of people with SMI should empower staff and service users and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered. PMID:29588643

Chronic Physical Illness and Mental Health in Children. Results from a Large-Scale Population Study

ERIC Educational Resources Information Center

Hysing, Mari; Elgen, Irene; Gillberg, Christopher; Lie, Stein Atle; Lundervold, Astri J.

2007-01-01

Background: The aim of the present study was to evaluate the sensitivity and specificity of the Strengths and Difficulties Questionnaire (SDQ) in detecting emotional and behavioural problems among children with chronic illness (CI). Methods: Parents and teachers of a population of primary school children in Norway (n = 9430) completed a…

41 CFR 101-8.301 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... illness, and specific learning disabilities. The term “physical or mental impairment” includes, but is not..., performing manual tasks, walking, seeing, hearing, speaking, breathing, learning and working. (3) Has a...

Welfare to Work? Impact of Maternal Health on Employment

PubMed Central

Romero, Diana; Chavkin, Wendy; Wise, Paul H.; Smith, Lauren A.; Wood, Pamela R.

2002-01-01

Objectives. This study investigated whether health problems among poor mothers of chronically ill children affect their ability to obtain and maintain employment. Methods. Mothers of children with chronic illnesses were surveyed at clinical and welfare agency sites in San Antonio, Tex. Results. There were distinct health differences according to mothers’ TANF and employment status. Mothers without TANF experience reported better physical and mental health and less domestic violence and substance use than did those who had TANF experience. Those not currently working had higher rates of physical and mental health problems. Conclusions. Poor maternal health is associated with need for cash assistance and health insurance. Policymakers must recognize that social policies promoting employment will fail if they do not address the health needs of poor women and children. PMID:12197974

[Frequency and consequences of financial problems in patients undergoing outpatient psychosomatic treatment].

PubMed

Wagner, Stefanie; Münster, Eva; Beutel, Manfred E

2010-01-01

About seven million people in Germany are affected by overindebtedness and insolvency. Being severely in debt is a very stressful situation that can result in social marginalisation, reducted overall activity, and physical and mental illness. The present study investigated the frequency of financial problems and their effects on physical and mental disorders at a university psychosomatic clinic. The study included a total of 659 patients. Their mental status was assessed with the Symptom Checklist (SCL-90-R), their physical status with the Gießener Beschwerdebogen (GBB). 37 percent of the subjects reported experiencing financial problems. We found that subjects with financial problems reported more physical and mental disorders than those without financial problems. Furthermore, therapists more often recommended that patients with financial problems receive inpatient therapy than patients without financial problems. The study suggests that financial problems should be included in any anamnesis, therapeutic recommendation, and actual therapy of patients in psychosomatic treatment.

Motivational factors associated with physical activity and quality of life in people with severe mental illness.

PubMed

Farholm, Anders; Sørensen, Marit; Halvari, Hallgeir

2017-12-01

There has been increasing interest for investigating the role of motivation in physical activity among people with severe mental illness (SMI). Autonomous motivation has been suggested to have a potentially important role in adoption and maintenance of physical activity. However, the knowledge about factors that facilitate autonomous motivation among people with SMI is scarce. The aim of this study was to examine factors associated with motivation for physical activity as well as the relationships between motivation, physical activity and health-related quality of life in individuals with SMI that were currently physically active. A cross-sectional design was used, and 88 participants were recruited from a public health network promoting physical activity for people with SMI. They answered a questionnaire package consisting of scales measuring psychological need support - psychological need satisfaction - and motivation for physical activity, physical activity and health-related quality of life. The majority of participants reported to be in regular physical activity. Associations between variables were tested according to the self-determination theory process model. Structural equation modelling yielded good fit of the process model to the data. Specifically, a need-supportive environment was positively associated with psychological need satisfaction, while psychological need satisfaction was positively associated with autonomous motivation and mental health-related quality of life, and negatively associated with controlled motivation and amotivation. Physical activity was positively associated with autonomous motivation and physical health-related quality of life, and negatively associated with amotivation. This study indicates that individuals with SMI can be regularly physically active when provided with suitable opportunities. Furthermore, the present results suggest that it is vital for health-care practitioners to emphasise creating a need-supportive environment when organising physical activity because such an environment is associated with both increased autonomous motivation for physical activity and mental health-related quality of life. © 2016 Nordic College of Caring Science.

Cultural misconceptions and public stigma against mental illness among Lebanese university students.

PubMed

Rayan, Ahmad; Fawaz, Mirna

2018-04-01

The purpose of this study was to examine cultural misconceptions about mental illness and how they are associated with the public stigma against mental illness among Lebanese university students. A sample of 203 participants completed the study. Data about cultural misconceptions, attitudes about mental illness, and public stigma of mental illness were obtained. The researchers examined the mean difference in public stigma according to cultural beliefs about mental illness. The majority of students believe that mental health professionals have inadequate knowledge and expertise to treat mental disorders. Various cultural misconceptions about mental illness were reported. Public stigma significantly differed based on these cultural misconceptions. Psychiatric nurses should play a vital role in reshaping the inappropriate cultural view about mental illness. © 2017 Wiley Periodicals, Inc.

Time trends in the incidence of work-related mental ill-health and musculoskeletal disorders in the UK.

PubMed

Carder, Melanie; McNamee, Roseanne; Turner, Susan; Hodgson, John Timothy; Holland, Fiona; Agius, Raymond M

2013-05-01

To determine UK trends (from 1996 to 2009) in incidence of work-related mental ill-health and musculoskeletal disorders, for all industry as well as for health and social care employees. Second, to investigate whether there may have been a recent shift from a physical to psychological perspective in how patients present their illness by comparing reporting trends for back pain and 'other work stress'. Multilevel models were used to investigate changes in incidence of work-related illness, as diagnosed by specialist physicians. The dependent variable comprised case reports to The Health and Occupation Research network. Comparisons were made between medical specialties, industry (health and social care vs all other employees), gender and diagnosis. Trends for Occupational Physicians' (OP) reporting mental ill-health (average annual increase +3.7% (95% CI +2.2% to +5.2%)) differed significantly (p<0.001) from psychiatrists' reporting over the same time period (-5.9% (95% CI -7.6% to -4.2%)). For OPs' reporting, the rate of increase was greater for females and for health and social care employees. A fall in incidence of musculoskeletal disorders for OPs of -5.8% (95% CI -7.3% to -4.3%) and rheumatologists' reporting -6.6% (95% CI -8.3% to -4.8%) was found, with little variation by gender or industry. Within health and social care, an increase in incidence of 'other work stress' was accompanied by a similar decrease in 'spine/back pain'. The evidence presented is consistent with a shift in the presentation of ill-health from a physical to psychological perspective, although changes in hazards, prevention measures and physician awareness should also be considered as explanations.

Mental health/psychiatric issues in elder abuse and neglect.

PubMed

Cooper, Claudia; Livingston, Gill

2014-11-01

Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.

Disease Management: The Need for a Focus on Broader Self-Management Abilities and Quality of Life

PubMed Central

Nieboer, Anna Petra

2015-01-01

Abstract The study objective was to investigate long-term effects of disease management programs (DMPs) on (1) health behaviors (smoking, physical exercise); (2) self-management abilities (self-efficacy, investment behavior, initiative taking); and (3) physical and mental quality of life among chronically ill patients. The study also examined whether (changes in) health behaviors and self-management abilities predicted quality of life. Questionnaires were sent to all 5076 patients participating in 18 Dutch DMPs in 2010 (T0; 2676 [53%] respondents). Two years later (T1), questionnaires were sent to 4350 patients still participating in DMPs (1722 [40%] respondents). Structured interviews were held with the 18 DMP project leaders. DMP implementation improved patients' health behavior and physical quality of life, but mental quality of life and self-management abilities declined over time. Changes in patients' investment behavior predicted physical quality of life at T1 (P<.001); physical activity, investment behavior (both P<.05), and self-efficacy (P<.01) at T0, and changes in self-efficacy and investment behavior (both P<.001) predicted patients' mental quality of life at T1. The long-term benefits of these DMPs include successful improvement of chronically ill patients' health behaviors and physical quality of life. However, these programs were not able to improve or maintain broader self-management abilities or mental quality of life, highlighting the need to focus on these abilities and overall quality of life. As coproducers of care, patients should be stimulated and enabled to manage their health and quality of life. (Population Health Management 2015;18:246–255) PMID:25607246

Disease Management: The Need for a Focus on Broader Self-Management Abilities and Quality of Life.

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2015-08-01

The study objective was to investigate long-term effects of disease management programs (DMPs) on (1) health behaviors (smoking, physical exercise); (2) self-management abilities (self-efficacy, investment behavior, initiative taking); and (3) physical and mental quality of life among chronically ill patients. The study also examined whether (changes in) health behaviors and self-management abilities predicted quality of life. Questionnaires were sent to all 5076 patients participating in 18 Dutch DMPs in 2010 (T0; 2676 [53%] respondents). Two years later (T1), questionnaires were sent to 4350 patients still participating in DMPs (1722 [40%] respondents). Structured interviews were held with the 18 DMP project leaders. DMP implementation improved patients' health behavior and physical quality of life, but mental quality of life and self-management abilities declined over time. Changes in patients' investment behavior predicted physical quality of life at T1 (P<.001); physical activity, investment behavior (both P<.05), and self-efficacy (P<.01) at T0, and changes in self-efficacy and investment behavior (both P<.001) predicted patients' mental quality of life at T1. The long-term benefits of these DMPs include successful improvement of chronically ill patients' health behaviors and physical quality of life. However, these programs were not able to improve or maintain broader self-management abilities or mental quality of life, highlighting the need to focus on these abilities and overall quality of life. As coproducers of care, patients should be stimulated and enabled to manage their health and quality of life.

'Treading water but drowning slowly': what are GPs' experiences of living and working with mental illness and distress in England? A qualitative study.

PubMed

Riley, Ruth; Spiers, Johanna; Chew-Graham, Carolyn A; Taylor, Anna K; Thornton, Gail A; Buszewicz, Marta

2018-05-03

This paper provides an in-depth account of general practitioners' (GPs) experiences of living and working with mental illness and distress, as part of a wider study reporting the barriers and facilitators to help-seeking for mental illness and burn-out, and sources of stress/distress for GP participants. Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. England. A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face to face or over the telephone. The findings report GP participants' in-depth experiences of distress and mental illness with many recollecting their distressing experiences and significant psychological and physical symptoms relating to chronic stress, anxiety, depression and/or burn-out, and a quarter articulating thoughts of suicide. Many talked about their shame, humiliation and embarrassment at their perceived inability to cope with the stresses of their job and/or their symptoms of mental illness. These findings paint a concerning picture of the situation affecting primary care doctors, with participants' accounts suggesting there is a considerable degree of mental ill health and reduced well-being among GPs. The solutions are complex and lie in prevention and provision. There needs to be greater recognition of the components and cumulative effect of occupational stressors for doctors, such as the increasing workload and the clinical and emotional demands of the job, as well as the need for a culture shift within medicine to more supportive and compassionate work environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

What can we do to reduce the burden of avoidable deaths in those with serious mental illness?

PubMed

Crompton, David; Groves, Aaron; McGrath, John

2010-01-01

Individuals with schizophrenia have higher mortality rates compared to the general community. Apart from an increased risk of suicide, people with schizophrenia have an increased risk of death related to a wide range of comorbid physical conditions. There is evidence to suggest that much of this mortality is avoidable. The provision of assertive management of comorbid physical disorders has the potential to help close the differential mortality gap. While the primary data are robust, there is less empirical evidence to guide policy makers and service providers when dealing with these problems. Focused clinical programs aimed at reducing risk factors (e.g. smoking, obesity) and shared care between mental health teams and primary care providers can help reduce the burden of avoidable deaths. In light of recent evidence suggesting that the mortality gap has widened in recent decades, there is an urgent need to address the burden of avoidable deaths in those with serious mental illnesses.

The effect of mental ill health on absence from work in different occupational classifications: analysis of routine data in the British Household Panel Survey.

PubMed

Whittaker, Will; Sutton, Matt; Macdonald, Sara; Maxwell, Margaret; Smith, Michael; Wilson, Philip; Morrison, Jill

2012-12-01

To investigate relationship of mental ill health to absence from work in different occupational classifications. Examined sickness absence, mental health (GHQ-12), physical health, job characteristics, and personal characteristics in 18 waves of the British Household Panel Survey. Overall sickness absence rate was 1.68%. Increased absence was associated with age greater than 45 years, female gender, lower occupational classification, and public-sector employers. Decreased absence was associated with part-time working. Scoring 4 or more on the General Health Questionnaire 12-item version (GHQ-12 caseness) was strongly associated with sickness absence. Public-sector employers had highest rates of sickness absence. GHQ-12 caseness had largest impact on absence in the public and nonprofit sectors, whereas physical health problems impacted more in the private sector. GHQ-12 caseness is strongly associated with increased absence in all classifications of occupations. Differences between sectors require further investigation.

Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans: Does Supported Housing Matter?

PubMed

Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Gelberg, Lillian

2016-10-01

Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless-now housed/case managed through VA Supported Housing ("VASH Veterans")-and currently homeless. We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated-adjusting for demographics and need characteristics in regression analyses-between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. © The Author(s) 2016.

Mental Illness in Blacks: An Overview, and Treatment Approaches

PubMed Central

Davis, Elizabeth B.

1979-01-01

Provisions for inner city mental health services must recognize the association between poverty, discrimination, and related social and physical conditions and disproportionately high rates of severe mental disorder—a transcultural phenomenon. Program emphasis should therefore be on the prevention, early recognition, prompt and effective treatment and rehabilitative care of psychosis. The total spectrum of psychiatric services is required for this, and thus an opportunity is afforded for necessary training and research. Poverty has negative impact on general health and cognitive development as well as on self-esteem, self-care, and the ability to utilize medical and health services. This contributes to a vicious, intergenerational poverty cycle. Primary prevention of mental illness, where possible, depends at present on socioeconomic change. Secondary prevention, ie, timely, appropriate treatment, is effective, but requires patient access to and acceptance of all indicated modalities of care. PMID:537113

26 CFR 54.9801-2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... physical or mental, including, but not limited to, any condition resulting from illness, injury (whether or... relationship to a participant. Employee Retirement Income Security Act of 1974 (ERISA) means the Employee...

26 CFR 54.9801-2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... physical or mental, including, but not limited to, any condition resulting from illness, injury (whether or... relationship to a participant. Employee Retirement Income Security Act of 1974 (ERISA) means the Employee...

26 CFR 54.9801-2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... physical or mental, including, but not limited to, any condition resulting from illness, injury (whether or... relationship to a participant. Employee Retirement Income Security Act of 1974 (ERISA) means the Employee...

26 CFR 54.9801-2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... physical or mental, including, but not limited to, any condition resulting from illness, injury (whether or... relationship to a participant. Employee Retirement Income Security Act of 1974 (ERISA) means the Employee...

Giardia: Illness & Symptoms

MedlinePlus

... physical and mental growth, slow development, and cause malnutrition 2 , 11 , 13-17 . References Huang DB, White ... and treatment of giardiasis in chronic diarrhoea and malnutrition. [PDF - 3 pages] Arch Dis Child. 1991;66( ...