Case Report of Multiple Physical Illnesses in Persons with Serious Mental Illness: Can’t Recovery in Mental Health Pave the Way to Recovery in Physical Health and or or Conversely? - Abstract
People with serious mental illness (SMI: schizophrenia, schizotypal disorder and delusional disorder, as defined in Chapter 5 of the International Classification of Diseases) have significantly higher medical comorbidities and a much lower life expectancy compared with the general population. In fact, an excess mortality rate due to a chronic physical illness (CPI), among these patients, is such that their life expectancy could be lessened by up to 20 years. Of great concern is that this inequitable risk of premature death has been increasing in recent decades, even in countries with universal healthcare systems like the UK or Canada. Studies have shown that even when accepted for the treatment of a CPI, patients with SMI are less likely to have comprehensive reviews. There is also a greater delay for medical and surgical interventions when compared to the general population. To address this problem, a pilot study was undertaken in East-end Montreal, Canada. This paper reports the combinations of CPIs among SMI patients (N=142). Managing CPIs is more complex when combined with mental illness, even more so when they are multiple. A range of health professionals who work with patients is needed to promote recovery-oriented self-care behaviors and provide therapeutic education. Although this may exceed psychiatric services per se, it is important for mental health practitioners to acknowledge and keep in mind an overview of CPI management and care pathways for SMI patients who may be particularly at risk of functional deficits and of not having easy access to primary care professionals.