The somatic care situation of people with mental illness

Health Sci Rep. 2020 Dec 21;4(1):e226. doi: 10.1002/hsr2.226. eCollection 2021 Mar.

Abstract

Background and aims: People with mental illness have worse physical health and reduced life expectancy compared to the general population. Nevertheless, their medical care is often insufficient. The present study aimed to investigate the somatic status of people with mental illness with a focus on somatic diagnoses, metabolic risk factors, regular somatic care, and routine check-ups.

Methods: This study used a 14-item questionnaire to survey the somatic care situation of psychiatric university hospital patients. Main survey topics were psychiatric and somatic diagnoses, metabolic risk factors, regular somatic care, and routine check-ups.

Results: Four-hundred and thirty-five people with mental illness (48.3% male, mean age 45.4 years) were included. More than three quarters of the participating people with mental illness had access to a general practitioner. People with affective and anxiety disorders reported significantly more contact with medical specialists for somatic diseases, but schizophrenic patients did not receive enough care. Not all people with mental illness and on psychiatric medication received regular somatic care. Somatic diseases increased with number of diagnoses, and the duration of the psychiatric illness was positively correlated with treatment motivation.

Conclusion: The observed unmet medical needs in this study might reflect the lack of treatment motivation in people with mental illness, but could also represent their obstacles to access care as well as a suboptimal communication between the treating psychiatrist and the referring general practitioner. Increasing awareness of somatic diseases in psychiatric patients and easier access to somatic care have to be implemented in psychiatric clinical routine. The risk of stigmatization in somatic institutions and the lack of self-care management in people with mental illness are complicating factors.

Keywords: cardiovascular risk factors; mental illness; physical health; somatic care; treatment motivation.