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Lee K, Akinola A, Abraham S. Antipsychotic-induced weight gain: exploring the role of psychiatrists in managing patients' physical health - challenges, current options and direction for future care. BJPsych Bull 2024; 48:24-29. [PMID: 37165776 PMCID: PMC10801410 DOI: 10.1192/bjb.2023.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/12/2023] [Accepted: 04/02/2023] [Indexed: 05/12/2023] Open
Abstract
Antipsychotics and severe mental illness (SMI) are associated with weight gain, and obesity increases the risks of cardiometabolic disease and premature death. These present management and liability issues for psychiatrists. Physical healthcare for people with SMI is poor, and this may partly be owing to training limitations and lack of proactiveness by psychiatrists. Ethically and legally, psychiatrists have a duty to avoid unnecessary harm and to maintain an acceptable standard of care. This would apply particularly to patients receiving compulsory treatment for their SMI owing to their vulnerability. Discrepancy between psychiatric and non-psychiatric approaches to pharmacological treatment creates ambiguity, and weight gain could demotivate antipsychotic adherence. This article explores how the Mental Health Act could be used to address these issues, and the ethical considerations, and proposes how long-acting glucagon-like peptide-1 receptor agonists could be introduced into existing psychiatric practice as a treatment option for antipsychotic-induced weight gain and obesity in SMI.
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Affiliation(s)
- Kenn Lee
- Pennine Care NHS Foundation Trust
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Aloudah NM, Almanea H, Alotaibi K, Al Rubeaan KA. Quality of diabetes care among patients with schizophrenia. A mixed-methods study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 4:100070. [PMID: 35479839 PMCID: PMC9029903 DOI: 10.1016/j.rcsop.2021.100070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/11/2021] [Accepted: 09/11/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives Patients with schizophrenia are at high risk of developing diabetes. Our study aimed to determine the prevalence of diabetes in patients with schizophrenia and assess their quality of diabetes care. We further aimed to explore the factors affecting diabetes care in patients with schizophrenia. Research design and methods We conducted a retrospective review of medical records for patients presenting with schizophrenia from October 2017 to October 2018. Thereafter, we conducted semi-structured interviews based on the Theoretical Domains Framework to explore healthcare providers' attitudes and perspectives toward diabetes care in patients with schizophrenia at a tertiary hospital for mental health services in Saudi Arabia. Results The prevalence of diabetes in patients with schizophrenia was 3.7%. The rates of annual testing for quality indicators of diabetes were 8.6% for HgbA1c and 31.4% for low-density lipoprotein cholesterol (LDL-C). Screenings for albuminuria and examinations of the eyes and feet were not conducted. Documentation of smoking status was done infrequently (8.6%). The in-depth interviews uncovered issues with managing diabetes in patients with schizophrenia. We identified four themes: the consequences of poor quality diabetic care provided to patients with schizophrenia; problems with the identification of diabetes in patients with schizophrenia; challenges in the management of patients with both diabetes and schizophrenia; and opportunities to improve the quality of diabetes care provided to patients with schizophrenia. Conclusions This study identified areas that need a considerable amount of work to be undertaken in Saudi Arabia to help patients with schizophrenia. There are numerous opportunities for improving the quality of Type 2 diabetes care such as the involvement of pharmacists to effectively manage diabetes and expanding community-based health services to include mental health, which could accelerate improved care services.
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Sugawara N, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Matsuda H, Suzuki Y, Ozeki Y, Okamoto K, Sagae T, Someya T. Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan. Neuropsychiatr Dis Treat 2020; 16:2229-2236. [PMID: 33061393 PMCID: PMC7533264 DOI: 10.2147/ndt.s269619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan. METHODS In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease. RESULTS The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02-0.06), 0.54 (95% CI 0.48-0.60), 2.77 (95% CI 2.44-3.14) and 8.75 (95% CI 7.40-10.36) for BMI <20 kg/m2, 20 kg/m2 ≤ BMI < 25 kg/m2, 25 kg/m2≤ BMI < 28 kg/m2, and 28 kg/m2≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05-0.12), 0.73 (95% CI 0.66-0.82), 2.50 (95% CI 2.16-2.90) and 4.83 (95% CI 4.12-5.67) for the same BMI categories, respectively. CONCLUSION The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m2.
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Affiliation(s)
- Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Manabu Yamazaki
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Takao Mori
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
| | - Hiroshi Matsuda
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
| | - Yuji Ozeki
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan
| | - Kurefu Okamoto
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Toyoaki Sagae
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan.,Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
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Happell B, Platania-Phung C, Bocking J, Ewart SB, Scholz B, Stanton R. Consumers at the centre: interprofessional solutions for meeting mental health consumers’ physical health needs. J Interprof Care 2018; 33:226-234. [DOI: 10.1080/13561820.2018.1516201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | | | - Julia Bocking
- Synergy, Nursing and Midwifery Research Centre, University of Canberra, WODEN, Australia
| | | | - Brett Scholz
- Research Fellow ANU Medical School, College of Health and Medicine, The Australian National University, Woden Canberra, Australia
| | - Robert Stanton
- School of Medical and Applied Sciences Bruce Highway, Central Queensland University, Rockhampton, Australia
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Simoons M, Mulder H, Doornbos B, Schoevers RA, van Roon EN, Ruhé HG. Monitoring of somatic parameters at outpatient departments for mood and anxiety disorders. PLoS One 2018; 13:e0200520. [PMID: 30130372 PMCID: PMC6103503 DOI: 10.1371/journal.pone.0200520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/28/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Somatic complications account for the majority of the 13-30 years shortened life expectancy in psychiatric patients compared to the general population. The study aim was to assess to which extent patients visiting outpatient departments for mood and anxiety disorders were monitored for relevant somatic comorbidities and (adverse) effects of psychotropic drugs-more specifically a) metabolic parameters, b) lithium safety and c) ECGs-during their treatment. METHODS We performed a retrospective clinical records review and cross-sectional analysis to assess the extent of somatic monitoring at four outpatient departments for mood and anxiety disorders in The Netherlands. We consecutively recruited adult patients visiting a participating outpatient department between March and November 2014. The primary outcome was percentage of patients without monitoring measurements. Secondary outcomes were number of measurements per parameter per patient per year and time from start of treatment to first measurement. RESULTS We included 324 outpatients, of whom 60.2% were female. Most patients were treated for depressive disorders (39.8%), anxiety disorders (16.7%) or bipolar or related disorders (11.7%) and 198 patients (61.1%) used at least one psychotropic drug. For 186 patients (57.4%), no monitoring records were recorded (median treatment period 7.3 months, range 0-55.6). The median number of measurements per parameter per year since the start of outpatient treatment for patients with monitoring measurements was 0.31 (range 0.0-12.9). The median time to first monitoring measurement per parameter for patients with monitoring measurements was 3.8 months (range 0.0-50.7). DISCUSSION Somatic monitoring in outpatients with mood and anxiety disorders is not routine clinical practice. Monitoring practices need to be improved to prevent psychiatric outpatients from undetected somatic complications.
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Affiliation(s)
- Mirjam Simoons
- Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, The Netherlands
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion regulation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Pharmacotherapy, -Epidemiology & -Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Hans Mulder
- Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, The Netherlands
- Mental Health Services Drenthe, Assen, The Netherlands
| | | | - Robert A. Schoevers
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion regulation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Eric N. van Roon
- Department of Pharmacotherapy, -Epidemiology & -Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
- Department of Clinical Pharmacy and Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Henricus G. Ruhé
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion regulation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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Ewart SB, Happell B, Bocking J, Platania‐Phung C, Stanton R, Scholz B. Social and material aspects of life and their impact on the physical health of people diagnosed with mental illness. Health Expect 2017; 20:984-991. [PMID: 28295883 PMCID: PMC5600237 DOI: 10.1111/hex.12539] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND 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. OBJECTIVE To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health-care services. DESIGN Qualitative exploratory design involving focus groups. SETTING AND PARTICIPANTS The research was conducted in the Australian Capital Territory. Participants were consumers of mental health services. MAIN OUTCOME MEASURES The Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts. RESULTS 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. DISCUSSION AND CONCLUSIONS 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.
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Affiliation(s)
- Stephanie B. Ewart
- SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberra HospitalWodenACTAustralia
| | - Brenda Happell
- SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberra HospitalWodenACTAustralia
| | - Julia Bocking
- SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberra HospitalWodenACTAustralia
| | - Chris Platania‐Phung
- SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberra HospitalWodenACTAustralia
| | - Robert Stanton
- School of Medical and Applied SciencesCentral Queensland UniversityRockhamptonQLDAustralia
| | - Brett Scholz
- SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberra HospitalWodenACTAustralia
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Murphy AL, Gardner DM, Kisely S, Cooke CA, Kutcher SP, Hughes J. System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents. Clin Child Psychol Psychiatry 2016; 21:634-648. [PMID: 26614572 PMCID: PMC5094295 DOI: 10.1177/1359104515617518] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There are significant controversies regarding rising antipsychotic prescription trends in children and adolescents. Many pharmacoepidemiology trend studies have been published, and interpretations of these data are helpful in explaining what is happening in prescribing practices, but not why these patterns exist. There is a lack of qualitative data in this area, and the experience of prescribing antipsychotics to children and adolescents has not been adequately researched. We conducted a qualitative study using an interpretive phenomenological analysis of physicians' experiences of antipsychotic prescribing to children and adolescents. Prescribers participated in individual interviews and a focus group. We used a staged approach for data analysis of transcriptions. In all, 11 physicians including psychiatrists and general practitioners participated in our study. We identified themes related to context, role and identity, and decision-making and filtering Struggles with health system gaps were significant leading to the use of antipsychotics as substitutes for other treatments. Physicians prescribed antipsychotics to youth for a range of indications and had significant concerns regarding adverse effects. Our results provide knowledge regarding the prescribers' experience of antipsychotics for children and adolescents. Important gaps exist within the health system that are creating opportunities for the initiation and continued use of these agents.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, Canada .,Department of Psychiatry, Dalhousie University, Canada
| | - David M Gardner
- College of Pharmacy, Dalhousie University, Canada.,Department of Psychiatry, Dalhousie University, Canada
| | - Steve Kisely
- School of Population Health, University of Queensland, Australia
| | | | - Stanley P Kutcher
- Department of Psychiatry, Dalhousie University, Canada.,Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University and IWK Health Centre, Canada
| | - Jean Hughes
- School of Nursing, Dalhousie University, Canada
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Lui K, Randhawa G, Totten V, Smith AE, Raese J. Is Metabolic Syndrome On the Radar? Improving Real-Time Detection of Metabolic Syndrome and Physician Response by Computerized Scan of the Electronic Medical Record. Prim Care Companion CNS Disord 2016; 18:15m01849. [PMID: 27247842 DOI: 10.4088/pcc.15m01849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/19/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Metabolic syndrome is a common underdiagnosed condition among psychiatric patients exacerbated by second-generation antipsychotics, with the exception of aripiprazole and ziprasidone. This study evaluated the prescribing and treating behavior with regard to antipsychotics and metabolic syndrome of psychiatrists before and after implementation of a mandatory admission order set and electronic notification of results. METHOD Baseline data from 9,100 consecutive psychiatric admissions to a mental health hospital (July 2013-July 2014) were compared to postintervention data (July 2014-January 2015), which included 1,499 consecutive patient records. The intervention initiated standardized admission testing with electronic notification to psychiatrists when patients met metabolic syndrome criteria (according to Axis III of the DSM-IV). Charts were examined for inclusion of this diagnosis at discharge and for treatment changes. RESULTS At baseline, only 2.4% of patients (n = 214) were evaluated for metabolic syndrome. Of these, 34.5% (0.8% of the total sample) met metabolic syndrome criteria. Only 15 patients (0.16%) were comprehensively treated. No chart listed metabolic syndrome under Axis III of the DSM-IV. After the intervention, the diagnosis of patients meeting the criteria for metabolic syndrome increased from 0% to 29.3%. Less than 3% of patients were switched to drugs with a more benign metabolic profile. All patients who continued on second-generation antipsychotics had metabolic retesting. Thirty-eight experienced a significant and rapid increase in triglyceride levels after only 3 to 17 days. CONCLUSIONS Mandatory intake testing increases the number of patients evaluated for metabolic syndrome. Electronic alerts increase the inclusion of metabolic syndrome among discharge diagnoses but rarely affect prescribing practices.
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Affiliation(s)
| | | | | | - Adam E Smith
- Statistical and Research Consultant, Kaweah Delta Health Care District, Visalia, California
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Sugawara N, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Matsuda H, Suzuki Y, Minami Y, Ozeki Y, Okamoto K, Sagae T, Someya T. Attitudes toward metabolic adverse events among patients with schizophrenia in Japan. Neuropsychiatr Dis Treat 2016; 12:427-36. [PMID: 26966364 PMCID: PMC4771408 DOI: 10.2147/ndt.s98711] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Metabolic syndrome is a growing concern among patients with schizophrenia because metabolic abnormalities are widely regarded as a major risk factor for cardiovascular disease and premature death. The current study assessed attitudes toward metabolic adverse events among patients with schizophrenia. METHODS A brief questionnaire was constructed to investigate patient recognition of the following broad areas: dietary habits, lifestyle, self-monitoring, knowledge, and medical practice. Between January 2012 and June 2013, questionnaires were sent to patients associated with 520 outpatient facilities and 247 inpatient facilities belonging to the Japan Psychiatric Hospital Association. All of the participants (n=22,072; inpatients =15,170, outpatients =6,902) were diagnosed with schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or the International Classification of Diseases, tenth revision. RESULTS Approximately 55.0% (8,069/14,669) of inpatients and 44.8% of outpatients (2,978/6,649) reported that they did not exercise at all. Although 60.9% (4,116/6,760) of outpatients reported that they felt obese, only 35.6% (5,261/14,794) of inpatients felt obese. More than half of the inpatients (51.2%; 7,514/14,690) and outpatients (60.8%; 4,086/6,721) hoped to receive regular blood tests to prevent weight gain and diseases such as diabetes. CONCLUSION Although more than half of patients hoped to prevent weight gain and diabetes, only a minority of patients were mindful of eating balanced meals and having physical exercise. Educational efforts and the promotion of the best pharmacotherapy and monitoring practices are needed for patients with schizophrenia.
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Affiliation(s)
- Norio Sugawara
- Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan; Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | | | - Kazutaka Shimoda
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Takao Mori
- Japan Psychiatric Hospital Association, Tokyo, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Yuji Ozeki
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | | | - Toyoaki Sagae
- Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Happell B, Platania-Phung C, Webster S, McKenna B, Millar F, Stanton R, Galletly C, Castle D, Furness T, Liu D, Scott D. Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia. AUST HEALTH REV 2015; 39:370-378. [DOI: 10.1071/ah14098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/27/2015] [Indexed: 02/02/2023]
Abstract
Objectives The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. Methods A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013–2020 as an evaluative framework. Results National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised. What is known about the topic? People with mental illness have a lower life expectancy and poorer physical health than people who do not have a mental illness. Government policy is critical to reducing inequalities in physical health and increasing longevity. What does this paper add? Evaluating policy developments against the World Health Organization’s Mental Health Action Plan 2013–2020, this review identified a lack of cohesive national-level policy on how to improve the physical health of people with mental illness. Although there are some state-based policies regarding strategies for better prevention and management of the physical health of people with mental illness, evidence of policy implementation is either scarce or inconsistent. The capacity of current policy to translate into reforms that increase the physical and overall health of people suffering mental health difficulties seems very limited. What are the implications for practitioners? This paper outlines major policy gaps and an overall need for a national-level policy. National-level leadership on integrated health care is required, with monitoring to ensure health care reforms are genuinely informed by consumer and clinician views and are effective.
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