Mental health care professionals' accounts of actions and responsibilities related to managing physical health among people with severe mental illness

Birgitte Lerbæk, Rikke Jørgensen, Jørgen Aagaard, Julie Nordgaard, Niels Buus

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Life expectancy of people with severe mental illness (SMI) is greatly shortened compared to the general population, and despite extensive research, this issue is unsolved. Although it is widely recognised that people with SMI need support from health care services to manage health related issues, profound health inequalities exist within provision of health care. The aim of this study was to examine how mental health care professionals accounted for their actions and responsibilities related to managing physical health issues among people with SMI. Methods: Three focus groups were conducted with 22 mental health care professionals, employed at three mental health care locations. Participants' situated accounts were subjected to discourse analysis. Results: Participants accounted for actions and responsibilities in three typical ways; 1) by positioning people with SMI as difficult to motivate and actively resisting intervention, 2) by positioning people with SMI as so impaired that intervention was futile, and 3) by arguing they are undertreated for physical conditions and might have physical illnesses that staff are not aware of because of prominent mental illness. These discursive strategies seemed to legitimise situations where participants described not responding to physical health issues, and to downplay potential trouble in situations where participants described not succeeding in facilitating lifestyle changes or promoting compliance to treatment of physical conditions. Discussion and conclusion: Mental health care professionals need to increase their awareness of latent discriminating attitudes towards people with SMI. Such attitudes are suggested to reinforce barriers for people with SMI receiving physical health care.

Original languageEnglish
JournalArchives of Psychiatric Nursing
Volume33
Issue number2
Pages (from-to)174-181
Number of pages8
ISSN0883-9417
DOIs
Publication statusPublished - 1 Apr 2019

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Mental Health
Delivery of Health Care
Health
Life Expectancy
Focus Groups
Health Services
Life Style
Research
Population

Keywords

  • Discourse analysis
  • Focus groups
  • Physical health
  • Schizophrenia
  • Severe mental illness

Cite this

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title = "Mental health care professionals' accounts of actions and responsibilities related to managing physical health among people with severe mental illness",
abstract = "Background: Life expectancy of people with severe mental illness (SMI) is greatly shortened compared to the general population, and despite extensive research, this issue is unsolved. Although it is widely recognised that people with SMI need support from health care services to manage health related issues, profound health inequalities exist within provision of health care. The aim of this study was to examine how mental health care professionals accounted for their actions and responsibilities related to managing physical health issues among people with SMI. Methods: Three focus groups were conducted with 22 mental health care professionals, employed at three mental health care locations. Participants' situated accounts were subjected to discourse analysis. Results: Participants accounted for actions and responsibilities in three typical ways; 1) by positioning people with SMI as difficult to motivate and actively resisting intervention, 2) by positioning people with SMI as so impaired that intervention was futile, and 3) by arguing they are undertreated for physical conditions and might have physical illnesses that staff are not aware of because of prominent mental illness. These discursive strategies seemed to legitimise situations where participants described not responding to physical health issues, and to downplay potential trouble in situations where participants described not succeeding in facilitating lifestyle changes or promoting compliance to treatment of physical conditions. Discussion and conclusion: Mental health care professionals need to increase their awareness of latent discriminating attitudes towards people with SMI. Such attitudes are suggested to reinforce barriers for people with SMI receiving physical health care.",
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Mental health care professionals' accounts of actions and responsibilities related to managing physical health among people with severe mental illness. / Lerbæk, Birgitte; Jørgensen, Rikke; Aagaard, Jørgen; Nordgaard, Julie; Buus, Niels.

In: Archives of Psychiatric Nursing, Vol. 33, No. 2, 01.04.2019, p. 174-181.

Research output: Contribution to journalJournal articleResearchpeer-review

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AU - Jørgensen, Rikke

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AU - Buus, Niels

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