scholarly journals Meaningful patient engagement

2018 ◽  
Vol 24 (4) ◽  
pp. 245-251
Author(s):  
Clare Gerada
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Patient Engagement ◽  
Mentally Ill ◽  
Patient Perspective ◽  
Learning Objectives ◽  
List Type ◽  
Access To Services ◽  
The Individual ◽  
Health Programme

SUMMARYHolding a medical degree does not magically protect the individual from ever becoming unwell or needing medical help. However, for various reasons, most of which relate to personal, professional and institutional stigma, doctors are often denied the care they so readily provide to their own patients. The author has been running a ‘sick doctor’ service for 10 years and this article describes, from the practitioner-patient perspective, the barriers to care and what can be done to improve doctors' access to services.LEARNING OBJECTIVES•Appreciate the external and internal risk factors for mental illness in doctors•Understand why doctors do not attend for care when mentally unwell•Acknowledge how mentally ill doctors are exposed to stigma and how this can be overcomeDECLARATION OF INTERESTC.G. is a partner of the Hurley Group who won the contract for PHP in 2008 and is employed by and leads the NHS Practitioner Health Programme.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

The Mentally Ill in Your Caseload

2016 ◽  
pp. 409-420
Author(s):  
Donald W. Winnicott
Keyword(s):  
Mental Illness ◽  
Environmental Factors ◽  
Social Workers ◽  
Social Worker ◽  
Mentally Ill ◽  
Emotional Development ◽  
The Social ◽  
Dynamic Psychology ◽  
The Individual

In this talk delivered to social workers, Winnicott brings his understanding of professional psychiatry, with its attempts to treat severe mental illness using a more humane approach, together with his belief in dynamic psychology—the emotional development of the individual derived from the study of psychoanalysis—into a closer connection with one another. He charts a brief outline of psychoanalysis and interprets the psychoses through it. He sees the importance of early environmental factors in mental illness and the possible effects of this on maturation. He comments on depression both normal and psychotic in type, on his theories of personalization, of feeling real, and, through early dependence, the gradual growth of the functioning self. He also gives an empathic view of the role of the social worker in the difficult work of treating acute mental ill health.

Mental illness and moral panic: a qualitative study of perceptions of a lnk between violent crime and mental illness

2011 ◽  
Vol 26 (S2) ◽  
pp. 529-529 ◽  
Author(s):  
R. Faruqui
Keyword(s):  
Qualitative Research ◽  
Mental Illness ◽  
Violent Crime ◽  
Mentally Ill ◽  
Media Coverage ◽  
Moral Panic ◽  
Public Perceptions ◽  
Mentally Ill Offenders ◽  
List Type ◽  
Stigma Of Mental Illness

IntroductionThe crime committed by mentally ill offenders has continued to attract higher degrees of media interest and concerns over public safety.ObjectivesTo explore study participants’ views over public perceptions of mental illness, and psychiatric illness and violent crime link.AimsTo study public percetions of mental illness.MethodsThe study was coducted using a qualitative research design, using audi-taped, semi-structured interviews of 8 University students and healthcare professionals. Qualitative research themes and categories were obtained through qualitative data analysis of interview transcripts.ResultsQualitative categories were obtained using open, axial, and selective coding of transcribed data. The analysis identified a public fear of mental illness displaying in rejection of mentally ill and through expressive communication using stigmatizing language. The study identified that the public sources of knowledge about mental illness are derived from family and peer contact and also through media exposure rather than formal learning opportunities in schools.The study highlights the need for a public policy debate on harmful effects of social stigma of mental illness and further need for ongoing attempts to educate general public and policy makers. Three major categories emerged through this process are:.1.Negative media portrayal of mental illness2.Sufferer stigma and caraer burden3.Mental illness and Moral PanicThe study identified that an atmosphere of moral panic exists against mental illness and that this moral panic is reflected in media coverage of crime by mentally ill offenders.ConclusionsStudy confirms negative public perceptions and stigma of mental illness.

scholarly journals Alcohol use disorders in people with intellectual disability

2018 ◽  
Vol 24 (4) ◽  
pp. 264-272 ◽  
Author(s):  
Fionnuala Williams ◽  
Christos Kouimtsidis ◽  
Alexander Baldacchino
Keyword(s):  
Intellectual Disability ◽  
Alcohol Use ◽  
Alcohol Use Disorders ◽  
Learning Objectives ◽  
List Type ◽  
Significant Issue ◽  
Successful Management ◽  
Addiction Services ◽  
Assessment And Treatment ◽  
The Individual

SUMMARYThis article initially highlights that although the prevalence of alcohol use disorders in people with intellectual disability (PWID) appears to be low, it is a significant issue. This group can be more vulnerable to the adverse effects of alcohol and it is likely that many PWID who have alcohol use disorders are not being identified. We go on to review the limited existing literature on treatment for PWID who have alcohol use disorders and the challenges in meeting the needs of this patient group. We explore how assessment and treatment of alcohol use disorders in this population can be and needs to be tailored to the needs of PWID on an individual basis. There is also discussion about the use of incapacity legislation to treat this group.LEARNING OBJECTIVES•Be aware that alcohol use disorders can be especially problematic for PWID, that such disorders can often go undetected and that adapted screening techniques may be needed to identify such problems•Understand the difficulties that this population has in accessing addiction services and that successful management of PWID who misuse alcohol is usually dependent on appropriate joint working between intellectual disability and addiction services•Be aware that PWID are not a homogeneous group, rather they vary widely in their abilities, necessitating interventions tailored to the individual, and that the use of compulsory measures to manage PWID who lack capacity regarding to their alcohol use should be done with cautionDECLARATION OF INTERESTNone.

scholarly journals Developing a methodology for measuring readiness in mental illness recovery

2011 ◽  
Vol 26 (S2) ◽  
pp. 1441-1441
Author(s):  
A.J. Marques ◽  
T. Nogueira ◽  
C. Queiros
Keyword(s):  
Mental Illness ◽  
Focus Group ◽  
Mentally Ill ◽  
Deep Understanding ◽  
Recovery Process ◽  
Active Role ◽  
Delphi Panel ◽  
People With Mental Illness ◽  
Definition Of ◽  
The Individual

IntroductionPsychosocial Rehabilitation is actually understood as essential to promote the effective improvement of quality of life of mental ill people. Recovery is view as a process where individual plays an active role, choosing their own way. In this process, readiness is the interest, desire and motivation of the individual in his rehabilitation, being ready to change.AimsDevelop a methodology to assess readiness of people with mental illness, and known the opinion of health professionals about this methodology.MethodsUsing the results of different studies, a methodology to assess readiness was developed and described. This description was after submitted to a focus group with six professionals and to a Delphi panel of 25 professionals, all evaluating the methodology to be used with people with schizophrenia.ResultsThe methodology developed includes several steps to apply with mentally ill people. The focus group discusses the methodology and the results agree with the conclusions of other studies and with theoretical constructs about this topic. The Delphi panel yields an agreement rate exceeding 90% and suggests the application of the methodology to people with schizophrenia.ConclusionsThe methodology developed to assess readiness of mentally ill people to change and define their own recovery process seems to be useful and provide a more deep understanding of individual differences linked to the process of recovery. Also seems to provide a translation into quantitative indicators and to identify the overall level of readiness, being a practical tool to support the definition of rehabilitation projects.

The psychosis risk timeline: can we improve our preventive strategies? Part 3: primary common pathways and preventive strategies

2019 ◽  
Vol 25 (05) ◽  
pp. 321-332
Author(s):  
Karen Romain ◽  
Alexandra Eriksson ◽  
Richard Onyon ◽  
Manoj Kumar
Keyword(s):  
Risk Factors ◽  
Psychiatric Disorders ◽  
Recent Literature ◽  
Learning Objectives ◽  
List Type ◽  
Preventive Strategies ◽  
Psychosis Risk ◽  
Preventive Work ◽  
Key Aspects ◽  
Inflammatory Changes

SUMMARYPsychosis is a recognised feature of several psychiatric disorders and it causes patients significant distress and morbidity. It is therefore important to keep knowledge of possible risk factors for psychosis up to date and to have an overview model on which further learning can be structured. This article concludes a three-part series. It gives a review of evidence regarding common pathways by which many risk factors come together to influence the development of psychosis and finalises our suggested overview model, a psychosis risk timeline. The three primary pathways considered are based on the major themes identified in this narrative review of recent literature and they focus on neurological, neurochemical and inflammatory changes. We link each back to the factors discussed in the first and second parts of this series that alter psychosis risk through different mechanisms and at different stages throughout life. We then consider and summarise key aspects of this complex topic with the aim of providing current and future clinicians with a model on which to build their knowledge and begin to access and understand current psychosis research and implications for future preventive work.LEARNING OBJECTIVESAfter reading this article you will be able to: •give an overview of common pathways thought to link identified risk factors with psychosis development•understand neurochemical, neurostructural and inflammatory changes associated with psychosis•demonstrate increased knowledge of possible preventive strategies.DECLARATION OF INTERESTNone.

Interventions to Address Violence Associated with Mental Illness

2008 ◽  
Vol 16 (6) ◽  
pp. 405-411 ◽  
Author(s):  
Russ Scott
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Case Management ◽  
Mentally Ill ◽  
Community Setting ◽  
Holistic Care ◽  
Mentally Ill Offenders ◽  
Access To Services ◽  
Care Access ◽  
Patients At Risk

Objectives: The aim of this paper is to consider the association between mental illness and violence, and discuss broad intervention approaches. Conclusion: The necessary elements of intervention to reduce violence by the mentally ill are holistic care, access to services and, where necessary, legal leverage. In the custodial setting, this includes screening, early intervention and treatment in prison, and assertive post-release case management to divert mentally ill offenders away from substance use and to support their return to the community. In the community setting, active case management, including access to inpatient beds and co-ordination between mental health services and other agencies, is crucial to providing continuity of care for patients at risk of violence in the community.

Development of a Tool to Improve Screening Rates for Cardiometabolic Risk Factors Associated with Mental Illness

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Newcomer ◽  
D. Haupt
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Cardiometabolic Risk ◽  
Plasma Lipids ◽  
Drug Effects ◽  
Premature Mortality ◽  
Public Health Approach

Major mental illness is associated with premature mortality, primarily from cardiovascular disease. Modifiable risk factors include obesity, smoking, hyperglycemia, dyslipidemia and hypertension, all prevalent in this population, and commonly underrecognized and undertreated. Public health guidelines for screening and interventions to lower risk have reduced cardiovascular mortality in the general population, but these improvements have not extended to mentally ill populations. Recent recommendations to screen in this population have come from psychiatric professional groups, and in relation to regulatory warnings on potential adverse drug effects. However, recent studies suggest low levels of monitoring, both pre- and post-guidelines and warnings.Public health interest is now directed at improving screening in this population. One of the barriers to increasing screening is limited awareness among mental health professionals of the details of existing public health guidelines that define specific risk thresholds, diagnostic values and treatment targets for adiposity, blood pressure, plasma glucose and plasma lipids levels. Quality assurance/quality improvement (QA/QI) tools to facilitate screening include data collection forms that educate about risk parameters and organize patient data in a manner that helps to track risk over time.This presentation will describe a specific QA/QI tool for screening and monitoring cardiometabolic risk in the mentally ill, based on published guidelines from the European Association for the Study of Diabetes (EASD) and the European Society for Cardiology (ESC). Cardiometabolic screening, along with treatment approaches and interventions to reduce risk, offers an established public health approach to lower morbidity and mortality in vulnerable populations.

Cardiovascular Risk Factors for People with Mental Illness

2001 ◽  
Vol 35 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Sandra Davidson ◽  
Fiona Judd ◽  
Damien Jolley ◽  
Barbara Hocking ◽  
Sandra Thompson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Alcohol Consumption ◽  
Cardiovascular Risk Factors ◽  
Mentally Ill ◽  
Salt Intake ◽  
Community Sample ◽  
Overweight And Obesity ◽  
Health Clinic

Objective: The objective of this study was to document the prevalence of risk factors for cardiovascular disease among people with chronic mental illness. Method: A cross-sectional survey was conducted of 234 outpatients attending a community mental health clinic in the North-western Health Care Network in Melbourne, Australia. Prevalence of smoking, alcohol consumption, body mass index, hypertension, salt intake, exercise and history of hypercholesterolemia was assessed. Results: Compared with a community sample, the mentally ill had a higher prevalence of smoking, overweight and obesity, lack of moderate exercise, harmful levels of alcohol consumption and salt intake. No differences were found on hypertension. Men, but not women, with mental illness were less likely to undertake cholesterol screening. Conclusions: Psychiatric outpatients have a high prevalence of cardiovascular risk factors which may account for the higher rate of cardiovascular mortality among the mentally ill. Further research is needed to trial and evaluate interventions to effectively modify risk factors in this vulnerable population.

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