IMPROVEMENT OF PHYSICAL HEALTH FOR CUSTOMERS WITH MENTAL ILLNESS
Improvement of physical health for customers with mental illness
People who are mentally ill experience a poorer physical health than the general. Several factors contribute to the poor physical health of mentally ill patients. These include lifestyle factors and medication side effects. Thus, it has led to the high rates of morbidity and mortally of the mentally ill patients than the general population. It has also been noted that one in three of the 100,000 people who die each year have mental illness. They also have higher rates of infectious diseases of non-insulin dependent diabetes, respiratory diseases and HIV and also some form of cancer. It has also been noted that their life span is reduced by almost a decade. It has also been noted that 12 – 18 % the expenditure of the NHS is linked to the mental health problems. The mental illness includes schizophrenia, major depression and bipolar. This disparity has been attributed to several factors like tobacco use and lower rates of exercise, some lifestyle choices. Therefore, people with mental illness suffer related hardships like unstable housing, lack of access to healthy foods, and stress. In addition to this, patients with mental illness face difficulty in accessing medical care (Meyer & Nasrallah, 2009).
Health behaviors can be the target in order to reduce the comorbidity and provide an improvement which is significant to the physical health of the mentally ill patient. These improvements can also be a benefit to the management of individual with psychiatric symptoms. Some of the interventions included, weight management, physical activities, smoking cessation, and decrease in alcoholism.
It has been realized that the number of people with severe mental illness are on the rise, hence, there is a need for better and improved clinical attention. Several may have contributed to the physical illness of these patients. These factors may include; undiagnosed diseases because of the sporadic physical risk screening and detection, negative stereotypes of people with mental illness which is held by health professionals and poor medications. The patients are entitled to a similar standard of health care service as the rest of the general population. Research which has been done substantially has shown that physical health and mental health are linked. The Community Mental Health Center (CMHC) is often a familiar resource which offers a variety of psychiatric and psychosocial services. These services normally receive service grants, which are meant to improve the wellness and physical status of the patients. It is a proof that people with mental health require a good physical and health care..
The general practitioners have a vital role in supporting the mentally ill patients to help them improve their physical health. They are the first people who are contacted for help. They are capable of identifying the physical health issue of the patient (Zephaniah, 2007). They are also capable of providing information and advice. The patient’s consent will be sought after or before any contact is made with the health provider like the dentist or specialist. The mental service should know the family members that are close to the patient so as to address the physical need of the patient.
It is important for the general practitioner that lives close to the patient to know and be up-to-date of the physical needs so as to ensure the best treatment and care is given. It will also help the mental service providers to make the right diagnosis for any physical illness that may arise and prescribe the right medication that won’t interfere with the medication that the patient might be taking for the mental illness (Tracy, 2011). The family members of the patient are entitled to the confidentiality requirements of the patient. This means that the confidentiality of the clinical records and personal record are protected by the mental service providers of the patient. Priorities should be given to this confidentiality of personal information for further treatment of the patient (Zephaniah, 2007).
Severely mentally ill patients should have regular physical health examinations, he or she should seek help from mental health service to make and attend physical health appointments, one should be given consent to contact the health providers so as to work together to address the physical health concerns. The data system that supports the mental health should be made strong in order to support the coding and recording of mental health patients. The patient should also seek emotional and practical support from the close family members. It is also necessary to make changes about nutrition and make changes in the diet and also exercises routinely (Tyrer, 2006).
For the promotion of better integration of behavioral health care and physical health care, a primary and behavioral health care integration program is established. This is intended to give primary care to adults who are mentally ill in the community of mental health centers and other behavioral health settings. The main features of these centers are to offer screening and referral for physical health care; the centers also have a tracking system for consumers’ physical health needs and outcomes. The centers also offer care and management and prevention and also wellness services (Zephaniah, 2007).
As mentioned earlier, high mortality rates in mentally ill patients is due to health risk factors which are modifiable (Levin & Becker, 2010). Their physical well-being should be monitored, these include; weight gains and obesity, blood pressure, dietary intake, activity level and exercise, use of tobacco and other substance abuse, including alcohol, the fasting blood levels of glucose, cardiovascular disease, high levels of cholesterol, dental health, and liver function tests. This physical health is easy to monitor and perform and can be performed much better by a health worker than doctors.
To begin with abdominal obesity, regardless of the medication prescribed, the psychiatrist should monitor the BMI and WC of the patient. Blood pressure has to be regularly assessed at every visit (Hennekens, 2007). A baseline measure of plasma glucose level for the patient should be collected before starting any treatment. The blood glucose measure should be conducted in a fasting state for basic reasons of being the most sensitive measurement for the detection and treatment of glucose abnormalities. It is also advisable to have random blood glucose checks. The physical screening and monitoring are well accepted by patients and can well be implemented in various settings (Hennekens, 2007).
It is easy to motivate patients with a mental disorder to take part in the fasting blood assessment and more importantly, getting the results and evaluating it (Linsley et al, 2011). Oral health is also applicable in the sense that it also needs to be scrutinized just in a similar manner as other physical health problems. Some risk factors for poor oral health like a medication side effects, and smoking of an individual needs to be assessed. Screening patients using an algorithm, monitoring form or risk chart is much simpler and detailed. Follow-up monitoring should be done at intervals that are appropriate (Maj, 2009). The assessment of physical health should be recorded on a chart that shows the time and the results of the assessment compared with other references.
Most patients are not aware of the need to have the knowledge required to make the lifestyle changes. The health workers who are responsible in taking care of the patients should be able to educate and motivate the patients on smoking, dieting and exercise. They should also be taught together with their family members and caregivers on healthy lifestyles and psych educational packages to facilitate them. Psych educational packages do not need a specialist to administer it or any special training, but it does need to be administered by the staff at the mental health clinic.
The ethical interventions for non-pharmacological include incorporating diet and physical activity modifications that are demonstrated in terms of preventing weight gain (Schulz, 2008). A healthy diet, quitting smoking and regular physical activity are some of the key components of lowering the prevalence and the impact of the modifiable risk factors. However, if the lifestyle intervention fails, other medication which includes statins, anti-hypertensive therapy or the anti-diabetic agents are indicated. These drugs should be managed for the general population. The development of a centralized electronic database has ultimately been a rewarding process towards the achievement of improved patient care and parity of esteem (Saxena et al, 2006).
The legal implications taken to improve the physical health of mentally ill patients are; prioritizing the needs of people affected by mental illness to curb premature mortality. Actions are also taken to ensure that smokers who are mentally ill are offered tailored support and intervention. The government should amend quality outcomes framework that will ensure that there is screening for mentally ill patients so that they can take certain medications. (Tyrer, 2006)
Other forms of intervention taken to treat physical health of a mentally ill patient may include mood stabilizing medications, which is helpful to people who have bipolar disorders. Hospitalization may be necessary only if the patient is acutely ill and may need intensive treatment. Community support is necessary since it helps the patient to feel accepted by the community. There should be an informed direction of future treatment research which will determine the studies needed and the integration of public health interest with scientific opportunities. (Saxena et al, 2006).
It is clearly evident from the carried out research that, there is a significant barrier to physical health treatment for this group of people. Therefore, these patients need encouragement and support. Thus a clinical, psychiatric disability rehabilitation services should step up and play a broader health Care so as to reduce the prevalence of physical illness and premature mortality for patients with severe mental illness. The whole system of approach that involve specialist for mental health services, general practice and community health need to improve the access to timely and effective physical health services. This can only be made successful by having a focus on accountability for the outcomes ( Zephania, 2007).
The approach which is optimal for caring for the physical health of patients diagnosed with serious mental disorder requires a professional approach, which is different to the care provided routinely by the general public (Phelan et al, 2006). It is also critical for policy makers who are involved in the development of state plans for Medicaid. The affordable care should be created to benefit the states to have well-established health homes that will be coordinated for primary and behavioral health. The approach can be accomplished within the organizational structure. It requires tailoring of the health care to the needs that are required by the mentally ill patient. It also requires a well-structured collaboration that should exist between the mental care professionals and the general practitioners (Phelan et al, 2006).
Legal implications for improving the physical health of patients are considering an annual mortality review as part of the contract for the mental health trust. This will monitor the impact and the extent to remit the audit, which will include all inpatient settings ( Thornicroft, 2013).
Ethical options include the inclusion of lifestyle modifications to the educational and the programs for the patients. The nutritional, exercise and behavioral strategies should be incorporated. The patients should be encouraged to improve their adherence to psychiatric and medical interventions. It is also evident that specialists for mental ill patients have an important role to play in supporting people to improve their physical health as part of overall health care. General practitioners and other primary health services which include the community health have also a central role to play in the provision of preventive health care and medical treatment ( Bodes, 2006).
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