TY - JOUR
AU - L. Beishon
AU - B. Hickey
AU - B. Desai
AU - D. Chari
AU - F. Davies
AU - R. Evley
AU - H. Subramaniam
AU - E. Mukaetova-Ladinska
AU - G. Maniatopoulos
AU - T. J. Welsh
AU - E. L. Sampson
AU - N. Sanganee
AU - P. Neville
AU - C. Clegg
AU - A. Donovan
AU - T. Dening
AU - A. P. Rajkumar
AU - T. Robinson
AU - C. Tarrant
A1 - 
AB - BACKGROUND: Older people with serious mental ill health have high levels of physical comorbidity. Despite this, mental health services receive limited physical health support from primary or secondary care. This study investigated the facilitators and barriers to delivering physical healthcare for older people in mental health settings. METHODS: In total, 54 semi-structured interviews (REC:22/IEC08/0022) were conducted with different stakeholders [staff (n = 28), patients (n = 7), carers (n = 19)] across two mental health hospitals. Interviews explored the facilitators and barriers to delivering physical healthcare for older people (>65 years) receiving secondary mental healthcare (dementia and psychiatric disorders). Data were analysed thematically, underpinned by a framework of integrated care for individuals living with multimorbidity. RESULTS: A 'multidisciplinary approach' was valued, particularly to identify patients for targeted physical health support. There was felt to be a loss of physical health 'training and skills' over time, particularly amongst nursing and medical staff. Admissions to the acute hospital were potentially avoidable through improved 'support and availability of physical health expertise', to provide more proactive than reactive care. Alongside improved training and support, managing advanced care planning, end of life care and polypharmacy were perceived to facilitate improved physical healthcare in mental health settings. CONCLUSIONS: Lack of senior physical health leadership (e.g. geriatrician or general practitioner) and loss of skills and confidence in managing physical health in mental health settings have led to a low threshold for admissions to the acute hospital. In particular, services should support advanced care planning and end of life care from physical causes in mental health settings.
AD - Department of Cardiovascular Sciences, University of Leicester, UK.; Leicester British Heart Foundation Centre of Research Excellence, UK.; Leicester National Institute for Health and Care Research Biomedical Research Centre.; The Evington Centre, Leicestershire Partnership Trust, UK.; Department of Health Sciences, University of Leicester, UK.; School of Psychology and Visual Sciences, University of Leicester, UK.; University of Leicester School of Business, University of Leicester, UK.; ReMindUK, Research Institute for Brain Health, Bath, UK.; Bristol Medical School, University of Bristol, Bristol, UK.; Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.; Academic Centre for Healthy Ageing, Whipps Cross Hospital, Barts Health NHS Trust, UK.; Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, UK.; NHS Leicester, Leicestershire & Rutland Integrated Care Board.; Age UK Leicester Shire & Rutland.; Institute of Mental Health, Mental Health & Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, UK.
AN - 40991318
BT - Age Ageing
C5 - Healthcare Disparities
CP - 9
DA - Aug 29
DO - 10.1093/ageing/afaf261
DP - NLM
IS - 9
JF - Age Ageing
LA - eng
N2 - BACKGROUND: Older people with serious mental ill health have high levels of physical comorbidity. Despite this, mental health services receive limited physical health support from primary or secondary care. This study investigated the facilitators and barriers to delivering physical healthcare for older people in mental health settings. METHODS: In total, 54 semi-structured interviews (REC:22/IEC08/0022) were conducted with different stakeholders [staff (n = 28), patients (n = 7), carers (n = 19)] across two mental health hospitals. Interviews explored the facilitators and barriers to delivering physical healthcare for older people (>65 years) receiving secondary mental healthcare (dementia and psychiatric disorders). Data were analysed thematically, underpinned by a framework of integrated care for individuals living with multimorbidity. RESULTS: A 'multidisciplinary approach' was valued, particularly to identify patients for targeted physical health support. There was felt to be a loss of physical health 'training and skills' over time, particularly amongst nursing and medical staff. Admissions to the acute hospital were potentially avoidable through improved 'support and availability of physical health expertise', to provide more proactive than reactive care. Alongside improved training and support, managing advanced care planning, end of life care and polypharmacy were perceived to facilitate improved physical healthcare in mental health settings. CONCLUSIONS: Lack of senior physical health leadership (e.g. geriatrician or general practitioner) and loss of skills and confidence in managing physical health in mental health settings have led to a low threshold for admissions to the acute hospital. In particular, services should support advanced care planning and end of life care from physical causes in mental health settings.
PY - 2025
SN - 0002-0729 (Print); 0002-0729
ST - Improving access to physical healthcare for older people in mental health settings: the ImPreSs-care qualitative study
T1 - Improving access to physical healthcare for older people in mental health settings: the ImPreSs-care qualitative study
T2 - Age Ageing
TI - Improving access to physical healthcare for older people in mental health settings: the ImPreSs-care qualitative study
U1 - Healthcare Disparities
U3 - 10.1093/ageing/afaf261
VL - 54
VO - 0002-0729 (Print); 0002-0729
Y1 - 2025
ER -