The Physical Health Care of Psychiatric Patients in Adult Mental Health Services

Published date01 March 2006
Pages21-26
Date01 March 2006
DOIhttps://doi.org/10.1108/13619322200600005
AuthorIrene Cormac,Michael Ferriter
Subject MatterHealth & social care
The Physical Health Care
of Psychiatric Patients in
Adult Mental Health Services
Irene Cormac
Consultant Forensic Psychiatrist
Rampton Hospital
Michael Ferriter
Senior Research Fellow
Rampton Hospital
Focus on…
eople with mental disorders should
receive the same standard of physical health care as
the general population. The Department of Health
aims to improve the physical health of the general
population and has produced a number of documents.
These include the national service frameworks on
mental health (Department of Health, 1999a),
coronaryheartdisease (Department of Health, 1999b),
diabetes mellitus (Department of Health, 2001a) and
older people (Department of Health, 2001b). A recent
White Paper,Choosing Health (Department of Health,
2004), has highlighted the importance of a healthy
lifestyle in promoting physical health and in disease
prevention.
Mental health services have a key role in
promoting the physical and mental wellbeing of their
patients. This paper describes physical health
problems prevalent in psychiatric patients and
suggests ways in which mental health services can
improve their patients’ physical health.
Physical health
All forms of mental disorder carry an increased risk of
premature death (Harris & Barraclough, 1998).
Patients with mental disorders have more physical
illness than the general population and have higher
rates of diabetes, cardiovascular and respiratory
diseases (Brown et al,2002; Joukamaa et al, 2001). In
Pthe community, patients were found to have health
risks such as an unhealthy diet, obesity, smoking and
lack of exercise (McCreadie, 2003). A study of long-
stay patients revealed high rates of smoking (71%) and
obesity (36%) and 54% had physical health problems
(Cormac et al, 2005).
Patients with schizophrenia have two to four times
the risk of developing the metabolic syndrome
characterised by abdominal obesity,dyslipidaemia,
glucose intolerance, insulin resistance and
hypertension (Saari et al,2005). Psychotropic
medication can cause weight gain and central
deposition of adipose tissue. It may also raise prolactin
levels leading to impaired sexual and endocrine
function. The National Institute for Clinical
Excellence (NICE) (2002) recommends regular
monitoring of cardiovascular risk factors and endocrine
disorders in patients with schizophrenia.
Older patients with mental disorders have the
same physical health problems as other older people.
However,the recognition of their physical disorders
may be moredifficult due to the effects of their
mental disorder (Jolley et al,2004). Patients with
organic mental disorders, such as dementia, can
experience difficulty in accessing primary care.
People with learning disabilities also tend to have
morephysical health problems, including sensory
impairments (30-40%) and epilepsy (13-24%), and up
to 30% also have physical disabilities (Lindsey, 2002).
These physical disabilities can be associated with
other health problems such as gastro-oesophageal
reflux, aspiration pneumonia and joint problems (ibid).
Research shows that patients with a mental
The Mental Health Review Volume 11 Issue 1 March 2006 ©Pavilion Publishing (Brighton) 2006 21

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