Patients' and health professionals' views on primary care for people with serious mental illness : focus group study

Objective To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting Six primary care trusts in the West Midlands. Participants Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and prefer-red to consult their own GP, who listened and was willing to learn, rather than be referred to a different,GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness

The prevalence of metabolic syndrome amongst patients with severe mental illness in the community in Hong Kong--a cross sectional study

Background: Patients with severe mental illness are at increased risk of developing metabolic disorders. The risk of metabolic syndrome in the Hong Kong general population is lower than that observed in western countries; however the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong is unknown. Method: This cross-sectional study aimed to estimate the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong and to identify the relationships between metabolic syndrome and socio-demographic, clinical and lifestyle factors. Results: A total of 139 patients with a diagnosis of severe mental illness participated in the study. The unadjusted prevalence of metabolic syndrome was 35%. The relative risk of metabolic syndrome in comparison with the general Hong Kong population was 2.008 (95% CI 1.59-2.53, p < 0.001). In a logistic regression model sleep disruption and being prescribed first generation antipsychotics were significantly associated with the syndrome, whilst eating less than 3 portions of fruit/vegetables per day and being married were weakly associated. Conclusion The results demonstrate that metabolic syndrome is highly prevalent and that physical health inequalities in patients with severe mental illness in Hong Kong are similar to those observed in western countries. The results provide sufficient evidence to support the need for intervention studies in this setting and reinforce the requirement to conduct regular physical health checks for all patients with severe mental illness

Body mass index dependent metabolic syndrome in severe mental illness patients

The aim of this study was to evaluate the body mass index dependent metabolic syndrome in severe mental illness patients in Gorgan. A total of 267 severe mental illness patients took part in this study. The prevalence of metabolic syndrome in severe mental illness patients in different body mass index were 6.67, 24.09 and 53.06. There were significant differences in the mean of waist circumference, HDL-cholesterol, triglyceride and fasting blood glucose in subjects with metabolic syndrome in different body mass index when compared with subjects without metabolic syndrome (p<0.05). The prevalence of high fasting glucose, low high density lipoprotein-cholesterol, high triglyceride levels, high waist circumference and high blood pressure were 14.23, 38.57, 41.57, 32.96 and 5.24, respectively. It shows that high triglyceride levels (41.57) and Low HDL-cholesterol levels (38.57) were the most frequent characteristics in comparison to other metabolic components. Our results show that, 26.96, 31.08, 21.35, 15.35 and 5.25 of subjects had zero, one, two, three and four criteria for metabolic syndrome, respectively. These results show that the prevalence of metabolic syndrome in severe mental illness patients in Gorgan is increased with elevated body mass index. The results of this study suggest that mental illness patients are at risk of metabolic syndrome, when the rate of body mass index increases. Risk factors such as high triglyceride level and low HDL-cholesterol may play an important role in the occurrence of metabolic syndrome in severe mental illness patients. © 2015, Asian Network for Scientific Information. All rights reserved

A Comprehensive Examination of the Pharmacist’s Role in Mental Illness

The number of people receiving mental illness diagnoses has increased in the last two decades. As one of the most accessible healthcare professionals, pharmacists need to be prepared to assist in the management of patients with mental illness. In this study, the objective was to see how pharmacists’ mental illness knowledge, acceptable social distance, familiarity, and perceived barriers may predict pharmacists’ attitude toward patients with mental illness and also their willingness to provide care to patients with mental illness. The secondary objectives of this study were to test for differences in knowledge, attitude, perceived barriers, and willingness to provide care based on type of degree type of pharmacy, gender, and location. This study utilized a descriptive, cross-sectional survey design to collect study data from a sample of 196 pharmacists. The respondents seemed to have an overall positive attitude towards patients with mental illness. Nearly 60% of pharmacists reported that their pharmacy education adequately trained them to work with patients with mental illness. In regard to education, pharmacists with a PharmD more strongly attributed physical symptoms to mental illness than did BSPharm-trained pharmacists. Most of the pharmacists perceived time available for pharmacist to give attention to patients as one of the most significant barriers. In terms of social distance, most pharmacists expressed that they would be willing to work alongside a person with mental illness than have same person as a babysitter for their child. Although, pharmacists held a somewhat positive perception of patients’ mental illness, there was still a stigma assessed. Due to this, there might be a need for educational interventions that will improve future pharmacists’ willingness to provide care to patients with mental illness

Portrayal of Mental Illness on Television: A Review of the Literature

The focus of this thesis is to present peer-reviewed studies relating to mental illness and television. Up to this point there has not been a review paper exclusively examining mental illness and television exclusively. For this review, only articles with a defined research design were included. Seven content analysis articles were identified measuring images of mental illness on television. Content analysis articles covered children's television, primetime entertainment programs, and soap operas. Five studies were identified surveying attitudes and beliefs of viewers after seeing images of mental illness on television. Research revealed that mental illness is portrayed negatively on television. Commonly, characters with mental illness are shown as violent, villainous, and unintelligent. Attitudes are affected by the number of hours of television watched, the viewer's education level, having direct experience with a person diagnosed with a mental illness, as well as seeing negative portrayals of mental illness on television.In the future, collaborative relationships to educate professionals working in media need to be established. Anti-stigma interventions should target specific populations that do not have regular contact with mentally ill patients. Future research needs to include the opinions and experiences of mental health service consumers. Current content analysis research focuses heavily on programs aired on American network television (ABC, NBC, CBS, and Fox); in the future original programs on cable networks should be included in the samples. Similarly, unscripted reality television is gaining popularity and should be considered for analysis in the future. When attitudes and beliefs are measured, the samples of participants surveyed need to be made up of a wide range of ages, education levels, and experiences, instead of the homogenized groups currently being surveyed. Public health professionals have a responsibility to be advocates to the mental health community. It is of public health significance to ensure the most accurate information is disseminated to the general public in order to reduce incorrect assumptions and negative stigmas surrounding mental illness

Spanish medical students’ attitudes and views towards Mental Health and Psychiatry: a multicentric cross-sectional study.

Objective The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students. Methods The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n= 113), Madrid; San Pablo-CEU (n=22), and Barcelona; UAB (n=36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon’s adapted questionnaire to investigate their view towards psychiatry. Results The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry. Conclusions Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student’s attitudes could favor an appropriate management of patients suffering from mental illness

Patient journeys: Stories of mental health care from Tokanui to mental health services, 1930s to the 1980s

This chapter is concerned with finding out about mental health patients - taking this term at the outset - and exploring how their stories might be found in different places from 1912. It considers, then, the shifting identities of patients over time, as well as exploring issues around how historians might productively locate stories and narratives of mental illness, hospitalisation, recovery, and sometimes, cycles of these. Overall, it situates Tokanui patients in a wider framework for mental health histories in New Zealand and seeks to find their stories among the many accounts of mental illness. Where the previous chapter considered changing modalities for treatment, and told patient stories sensitively to capture this from the perspective of a practising psychiatrist, this chapter is written from the point of patients, but also mediated by the view of the historian. It therefore asks readers to think about the ways we tell stories of mental health, as much as about the stories themselves

A Comprehensive Examination of the Pharmacist\u27s Role in Mental Illness

The number of people receiving mental illness diagnoses has increased in the last two decades. As one of the most accessible healthcare professionals, pharmacists need to be prepared to assist in the management of patients with mental illness. In this study, the objective was to see how pharmacists\u27 mental illness knowledge, acceptable social distance, familiarity, and perceived barriers may predict pharmacists\u27 attitude toward patients with mental illness and also their willingness to provide care to patients with mental illness. The secondary objectives of this study were to test for differences in knowledge, attitude, perceived barriers, and willingness to provide care based on type of degree type of pharmacy, gender, and location. This study utilized a descriptive, cross-sectional survey design to collect study data from a sample of 196 pharmacists. The respondents seemed to have an overall positive attitude towards patients with mental illness. Nearly 60% of pharmacists reported that their pharmacy education adequately trained them to work with patients with mental illness. In regard to education, pharmacists with a PharmD more strongly attributed physical symptoms to mental illness than did BSPharm-trained pharmacists. Most of the pharmacists perceived time available for pharmacist to give attention to patients as one of the most significant barriers. In terms of social distance, most pharmacists expressed that they would be willing to work alongside a person with mental illness than have same person as a babysitter for their child. Although, pharmacists held a somewhat positive perception of patients\u27 mental illness, there was still a stigma assessed. Due to this, there might be a need for educational interventions that will improve future pharmacists\u27 willingness to provide care to patients with mental illness

Quality of life in Romanian patients with schizophrenia based on gender, type of schizophrenia, therapeutic approach, and family history

The low quality of life of patients with schizophrenia has been extensively discussed and investigated. Various aspects from gender, socio-demographic profile, and/or type of neuroleptic treatment have been taken into account in describing this condition. The purpose of this study is to assess the perceived quality of life of Romanian patients suffering from schizophrenia and to correlate it with gender differences, type of schizophrenia, family history of psychiatric illness, and type of antipsychotic treatment. 143 patients diagnosed with schizophrenia according to DSM IV-TR and ICD 10 were included in the study. Social demographic data were documented and further assessment was performed using the Subjective Well Being under Neuroleptic Treatment Scale –the short form (SWN-S) and the short version of the WHO- Questionnaire for The Quality of Life (WHO-QoL-BREF). The mental functioning dimension was higher in men than women; the social integration dimension was higher for the residual type of schizophrenia. Emotional regulation and the capacity of social integration did not show significant differences between patients who had a family history of mental illness and those who did not. Levels of self-control and physical functioning were better for patients treated with atypical antipsychotics and who did not report a family history of psychiatric illness. All five dimensions of the SWN-S were higher in patients treated with atypical antipsychotics, compared to those who were treated with typical antipsychotics. The study showed that for people with schizophrenia mental functioning was better preserved in men, in patients who did not have a family history of psychiatric illness, and in patients who were treated with atypical antipsychotics. The level of social integration was better in patients who were treated with atypical antipsychotics but this effect depended on the type of schizophrenia