Attending to physical health in mental health services in Australia: a qualitative study of service users' experiences and expectations
Abstract
Evidence is unequivocal: the premature death of people with severe mental health problems is attributable primarily to cardiovascular disease, and healthcare provided is often suboptimal. With the overarching aim of improving outcomes, policies and guidelines oblige mental health services and psychiatrists to monitor cardio-metabolic health of patients and intervene as appropriate. Practice is highly variable; however, with ongoing debate about resourcing and responsibilities dominated by clinicians who have identified disinterest among patients as influencing practice. Seeking to balance discussion, we posed the question 'what do patients experience and expect of mental health services in relation to their physical health?' To answer it, we interviewed a convenience sample of 40 service users recruited from a mental health service in Australia, early in 2015. Data were analysed using the framework approach. With few regarding themselves as healthy, participants were commonly concerned about side effects of medication, weight and fitness but rarely mentioned tobacco smoking. Participants' accounts reinforce extensive research demonstrating variability in attention to physical health in mental health services. Reports by some participants of comprehensive care are encouraging, but widespread uncertainty about reasons for various assessments and denial of requests for management of medication side effects, including weight gain, gives cause for concern. Although participants in this study wanted to improve their health and health-related quality of life, they acknowledged that their motivation and ability to do so fluctuated with mental health. They expected clinicians to work proactively, especially when symptoms compromised capacity for self-care, and mental health services to provide or enable access to health-promoting interventions. Attention should be given, as a matter of priority, to creating conditions (culture and infrastructure) needed to support sustained attention to physical health within services and, importantly, to full engagement of service users in management of their physical health.
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The inclusion criteria and recruitment strategies of the clinical trials that predominantly produced the efficacy data may reduce the generalisability and external validity of their findings.
“However, the inclusion criteria and recruitment strategies of the clinical trials from which this efficacy data is predominantly derived may reduce the generalisability and external validity of their findings.242”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [242]
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- Authors
- Young, S. J., Praskova, A., Hayward, N., & Patterson, S.
- Affiliations
- Metro North Hospital and Health Service (AU)
- Griffith University (AU)
- Independent Lived Experience Consultant; Bath UK
- Corresponding author
- Patterson, Sue
- Venue
- Health & Social Care in the Community
- Publisher
- Hindawi Limited
- Published
- 2016-04-19
- Volume
- 25
- Issue
- 2
- Pages
- 602-611
- ISSN
- 0966-0410 (ISSN-L)
- OpenAlex
- W2340047203
- Cited by
- 31
- References
- 34
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 4
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health & Social Care in the Community (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion)
- Funders
- Caboolture Hospital Innovation and Research Program
- Metro North Mental Health, Metro North Hospital and Health Service
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- cardiometabolic health, service user experiences, adverse drug reactions, weight gain, smoking, health-related quality of life, self-care ability, clinician expectations, integrated care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Australia, Mental Disorders, Female, Health Status, Humans, Interviews as Topic, Male, Mental Health Services, Middle Aged, Physical Fitness, Quality of Life, Qualitative Research, Young Adult, Mortality, Premature
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