Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives
BackgroundA huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.798530/full |
| _version_ | 1818955008380502016 |
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| author | Laurence Kohn Wendy Christiaens Johan Detraux Jan De Lepeleire Marc De Hert Marc De Hert Benoit Gillain Benjamin Delaunoit Isabelle Savoye Patriek Mistiaen Vicky Jespers |
| author_facet | Laurence Kohn Wendy Christiaens Johan Detraux Jan De Lepeleire Marc De Hert Marc De Hert Benoit Gillain Benjamin Delaunoit Isabelle Savoye Patriek Mistiaen Vicky Jespers |
| author_sort | Laurence Kohn |
| collection | DOAJ |
| description | BackgroundA huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access, utilisation, and provision contribute to these poor physical health outcomes.MethodsA qualitative study, using semi-structured interviews, was set up to explore SMI patients' and healthcare professionals' perspectives on somatic health care in different psychiatric settings of the three Belgian regions (Flanders, Brussels, Wallonia). Interviews were digitally recorded and transcribed prior to qualitative inductive thematic analysis, using Nvivo software. The COnsolidated criteria for REporting Qualitative research (COREQ) were used for reporting methods and findings.ResultsCollaboration and information flows between psychiatric healthcare professionals, non-psychiatric healthcare professionals, and persons with SMI were troublesome. This seemed to be mainly due to stigma and prejudice and challenging communication and data transfer. Lack of sufficient training and experience to identify and treat somatic health problems in people with SMI (for psychiatrists and psychiatric nurses) and lack of psychiatric knowledge and feeling or sensitivity for psychiatric patients (for non-psychiatric healthcare professionals) further complicated adequate somatic health care. Finally, optimal somatic follow-up of patients with SMI was hampered by organisational problems (unavailability of equipment, unadapted infrastructure, understaffing, hospital pharmacy issues, and insufficient health promotion/lifestyle interventions), patient-related issues (unawareness of physical problems, non-adherence, need for accompaniment) and financial barriers.ConclusionThere is an urgent need for integrated somatic and mental healthcare systems and a cultural change. Psychiatrists and primary care providers continue to consider the mental and physical health of their patients as mutually exclusive responsibilities due to a lack of sufficient training and experience, poor or absent liaison links, time constraints and organisational and financial barriers. Modifying these aspects will improve the quality of somatic health care for these vulnerable patients. |
| first_indexed | 2024-12-20T10:31:14Z |
| format | Article |
| id | doaj.art-32ece0b491014b65ba121ad30b0df5f1 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-20T10:31:14Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-32ece0b491014b65ba121ad30b0df5f12022-12-21T19:43:44ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-01-011210.3389/fpsyt.2021.798530798530Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' PerspectivesLaurence Kohn0Wendy Christiaens1Johan Detraux2Jan De Lepeleire3Marc De Hert4Marc De Hert5Benoit Gillain6Benjamin Delaunoit7Isabelle Savoye8Patriek Mistiaen9Vicky Jespers10Belgian Health Care Knowledge Centre, Brussels, BelgiumBelgian Health Care Knowledge Centre, Brussels, BelgiumDepartment of Neurosciences, Public Health Psychiatry, University Psychiatric Center, Catholic University of Leuven, Kortenberg, BelgiumDepartment of Public Health and Primary Care, Catholic University of Leuven, Leuven, BelgiumDepartment of Neurosciences, Center for Clinical Psychiatry, University Psychiatric Center, Catholic University of Leuven, Kortenberg, BelgiumAntwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, BelgiumSociété Royale de Santé Mentale de Belgique, Ottignies, BelgiumCentre Régional Psychiatrique Les Marronniers, Tournai, BelgiumBelgian Health Care Knowledge Centre, Brussels, BelgiumBelgian Health Care Knowledge Centre, Brussels, BelgiumBelgian Health Care Knowledge Centre, Brussels, BelgiumBackgroundA huge and still growing mortality gap between people with severe mental illness (SMI) and the general population exists. Physical illnesses, mainly cardiovascular diseases, substantially contribute to the high mortality rates in patients with SMI. Disparities in somatic health care access, utilisation, and provision contribute to these poor physical health outcomes.MethodsA qualitative study, using semi-structured interviews, was set up to explore SMI patients' and healthcare professionals' perspectives on somatic health care in different psychiatric settings of the three Belgian regions (Flanders, Brussels, Wallonia). Interviews were digitally recorded and transcribed prior to qualitative inductive thematic analysis, using Nvivo software. The COnsolidated criteria for REporting Qualitative research (COREQ) were used for reporting methods and findings.ResultsCollaboration and information flows between psychiatric healthcare professionals, non-psychiatric healthcare professionals, and persons with SMI were troublesome. This seemed to be mainly due to stigma and prejudice and challenging communication and data transfer. Lack of sufficient training and experience to identify and treat somatic health problems in people with SMI (for psychiatrists and psychiatric nurses) and lack of psychiatric knowledge and feeling or sensitivity for psychiatric patients (for non-psychiatric healthcare professionals) further complicated adequate somatic health care. Finally, optimal somatic follow-up of patients with SMI was hampered by organisational problems (unavailability of equipment, unadapted infrastructure, understaffing, hospital pharmacy issues, and insufficient health promotion/lifestyle interventions), patient-related issues (unawareness of physical problems, non-adherence, need for accompaniment) and financial barriers.ConclusionThere is an urgent need for integrated somatic and mental healthcare systems and a cultural change. Psychiatrists and primary care providers continue to consider the mental and physical health of their patients as mutually exclusive responsibilities due to a lack of sufficient training and experience, poor or absent liaison links, time constraints and organisational and financial barriers. Modifying these aspects will improve the quality of somatic health care for these vulnerable patients.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.798530/fullphysical healthsevere mental illness (SMI)health disparitiesqualitative researchhealth carebarriers |
| spellingShingle | Laurence Kohn Wendy Christiaens Johan Detraux Jan De Lepeleire Marc De Hert Marc De Hert Benoit Gillain Benjamin Delaunoit Isabelle Savoye Patriek Mistiaen Vicky Jespers Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives Frontiers in Psychiatry physical health severe mental illness (SMI) health disparities qualitative research health care barriers |
| title | Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives |
| title_full | Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives |
| title_fullStr | Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives |
| title_full_unstemmed | Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives |
| title_short | Barriers to Somatic Health Care for Persons With Severe Mental Illness in Belgium: A Qualitative Study of Patients' and Healthcare Professionals' Perspectives |
| title_sort | barriers to somatic health care for persons with severe mental illness in belgium a qualitative study of patients and healthcare professionals perspectives |
| topic | physical health severe mental illness (SMI) health disparities qualitative research health care barriers |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.798530/full |
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