Diagnostic overshadowing of mental health conditions in UK health care
| Date | 24 May 2024 |
| Pages | 1370-1382 |
| DOI | https://doi.org/10.1108/MHSI-04-2024-0060 |
| Published date | 24 May 2024 |
| Subject Matter | Health & social care,Mental health,Social inclusion |
| Author | Zoe Jane Hale |
Diagnostic overshadowing of mental
health conditions in UK health care
Zoe Jane Hale
Abstract
Purpose –Diagnostic overshadowing (DO) may be contributing to the worsening physical health
outcomes for people diagnosed with mental health (MH) conditions. DO is a phenomenon researched
worldwide, but therehas been no systematic review of the evidence for its prevalencein UK health care.
This paper aims to add to this body of knowledge, expanding the understanding of what factors are
contributingto the poor physical well-beingof people with diagnosed MH conditions.
Design/methodology/approach –A systematic search of three databases was conducted and after
evaluation,three studies were selected for the review.
Findings –DO was found to have a high prevalence withstructural, staffing and patient issues identified
through a thematic analysis. Contemporary evidence shows themes identified are still impacting UK
health care. Collaborative working across mental and physical health teams, thorough and lengthy
assessments,and improved education for physicalhealth care staff have been cited as mitigating factors
to this practice.
Originality/value –To the best of the author’sknowledge, this paper is the first review of the evidence for
diagnosticovershadowing taking place in UK health care.
Keywords Diagnostic overshadowing, Mental health, Physical health inequalities, UK health care
Paper type Literature review
Introduction
In 2016, the Mental Health Taskforce published the Five-Year Forward View for Mental
Health (FYFVfMH), emphasising the need for parity to be given to the physical health of
patients living with mental health (MH) conditions in the UK. It recognised that people with
MH conditions were experiencing “one of the greatest health inequalities” and cited poor
access to physical health care and assessment as a contributing factor in this. The UK
Department of Health and Social Care (2017) responded by increasing funding and stating
the need for a collaborative approach to tackle the fracture between physical and mental
health. Treating both physical and mental wellbeing in harmony, and actively working
alongside patients to modify risk factors (such as diet, exercise and smoking) can greatly
reduce the disparity in mortality and morbidity (Dregan et al.,2020). A lack of training,
knowledge and understanding have been outlined as possible reasons for poor physical
health provision for MH patients (Hallyburton and Allison-Jones, 2022), which can be
improved with better collaborative working between professionals as outlined in the
FYFVfMH (Chuttoo and Chuttoo, 2019).
However, in the UK it is still estimated that those diagnosed with MH conditions may be seven
times more likely to die prematurely than the general population (Office for Health
Improvement and Disparities, 2023). Two out of three of these deaths are from preventable
physical health illnesses, with 60% attributed to cardiovascular, liver and respiratory
diseases; cancer; diabetes, and hypertension (National Health Ser vice England (NHS),
2023). Adequate management of physical health conditions requires consistent
Zoe Jane Hale is based at
Department of Mental
Health Nursing, School of
Nursing and Midwifery,
University of Bolton,
Greater Manchester, UK.
The author thanks Professor
Russell Gurbutt for the ongoing
support with the author’s
professional doctorate journey
and also acknowledges the
necessary encouragement and
help which Professor Russell
Gurbutt provided that made the
author believe in her skills and
capabilities and without whom,
the author would not have
made it to this point.
Erratum: It has come to the
attention of the publisher that
the article, Hale, Z.J. (2024),
“Diagnostic overshadowing of
mental health conditions in UK
health care”, Mental Health and
Social Inclusion, Vol. ahead-of-
print No. ahead-of-print. https://
doi.org/10.1108/MHSI-04-2024-
0060, incorrectly formatted the
acknowledgments section of
the article. This has been
corrected in the online version
of the article.
The publisher sincerely
apologises for this error and
any inconvenience caused.
PAGE 1370 jMENTAL HEALTH AND SOCIAL INCLUSION jVOL. 28 NO. 6 2024, pp. 1370-1382, ©Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-04-2024-0060
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