TY - JOUR
KW - Delivery of Health Care, Integrated
KW - Disease Progression
KW - Health Personnel
KW - Health Services Accessibility
KW - Healthcare Disparities
KW - Humans
KW - Mental Disorders/drug therapy
KW - Mental Health Services
KW - Quality of Health Care
KW - Social Stigma
KW - Socioeconomic Factors
AU - D. Lawrence
AU - S. Kisely
A1 - 
AB - There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.
BT - Journal of psychopharmacology (Oxford, England)
C5 - Healthcare Disparities
CP - 4 Suppl
CY - United States
DO - 10.1177/1359786810382058
IS - 4 Suppl
JF - Journal of psychopharmacology (Oxford, England)
N2 - There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.
PP - United States
PY - 2010
SN - 1461-7285; 0269-8811
SP - 61
EP - 68
EP - 
T1 - Inequalities in healthcare provision for people with severe mental illness
T2 - Journal of psychopharmacology (Oxford, England)
TI - Inequalities in healthcare provision for people with severe mental illness
U1 - Healthcare Disparities
U2 - 20923921
U3 - 10.1177/1359786810382058
VL - 24
VO - 1461-7285; 0269-8811
Y1 - 2010
ER -