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A role for mental health nursing in the physical health care of consumers with serious mental illness.
... Despite these recommendations, physical health moni- toring among people with SMI is often inadequate ( Baxter et al., 2016;Happell et al., 2016;Millar, Sands, & Elsom, 2014;Montejo, 2010). This has been attributed to a range of factors (De Hert et al., 2011), including a lack of training, guidelines and general awareness of the importance of phys- ical health monitoring (Happell, Platania-Phung, & Scott, 2013;Millar et al., 2014), concerns of increasing workloads (Dunbar, Brandt, Wheeler, & Harrison, 2010;Happell et al., 2011;Wilson, Randall, & Weaver, 2014), uncertainty among healthcare professionals regarding whose responsibility this task is (Barnes, Paton, Cavanagh, Hancock, & Taylor, 2007;Wilson et al., 2014), and staff attitudes regarding what falls within their clinical role (Chadwick & Withnell, 2016;Dunbar et al., 2010;Wilson et al., 2014). ...
... First, care coordinators discussed a sense of overstep- ping their role when attending to physical health. This cor- responds with previous reports that role identities and diffusion of responsibility among mental health staff can detract from physical healthcare provision ( Baxter et al., 2016;Happell et al., 2011;Wynaden et al., 2016). Even when mental health staff have been overtly positioned to attend to clients' physical health, challenges were reported due to the perceived incongruence with what was consid- ered a part of the culture of mental health services ( Dunbar et al., 2010;Wilson et al., 2014). ...
... Even when mental health staff have been overtly positioned to attend to clients' physical health, challenges were reported due to the perceived incongruence with what was consid- ered a part of the culture of mental health services ( Dunbar et al., 2010;Wilson et al., 2014). To improve physical health monitoring practices, previous literature has recom- mended role clarification and appointing specific members of mental health service staff as responsible for physical health monitoring ( Dunbar et al., 2010;Happell et al., 2011; Working Group for Improving the Physical Health of People with SMI, 2016), and training regarding the importance of attending to physical health for mental health staff ( Baxter et al., 2016;Happell et al., 2013;Wynaden et al., 2016). Our findings suggest that these efforts could prove more effective if staff training also explicitly addressed how staff roles and responsibilities are viewed. ...
Background
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.
Aims
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).
Methods
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.
Results
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.
Conclusion
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.
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