Chronic illness and its affect on mental health

Chronic Illness and mental health

No health without mental health. Mental health disorders are often associated with chronic illness and should be addressed as part of general health care. It was again promoted by WHO, as its theme on world mental health of 2010 was –  “Mental Health and Chronic Physical Illnesses”

• Targeted the management of depression associated with chronic physical illness.

Chronic illness

• Lasting more than 4 months.
• Require careful life long management  or intensive period of treatment.

Common risk factors associated with mental and  physical illness:

• Depression
• Smoking,
• Excessive alcohol consumption,
• sedentary life

Chronic physical illness can result in:

• Increased isolation.
• Increased worry
• Family strain
• Job loss
• Maladaptive health behaviors.

WHY INTEGRATE BEHAVIORAL HEALTH INTO PRIMARY CARE SETTINGS…

• Most people seek help for behavioral health problems in primary care settings.
• Behavioral health problems go,  undetected and untreated in primary care.
• People with common medical disorders like diabetes have higher rates of behavioral health  problems.
• When psychiatric disorders are not addressed in people with chronic medical illnesses, they have worse psychiatric and medical outcomes.
• Low income patients unlikely to receive appropriate care for psychiatric disorders.
• At primary care system presents opportunity to intervene early, prevent more disabling disorders.
• Reach people who cannot or will not access specialty behavioral health care. Chronic Illness and mental health

• Adult mental patients in behavioral health settings have common physical problems (cardiovascular disease, diabetes and hypertension).
• Medical conditions of the people in behavioral health settings often go unrecognized.
• People with severe mental illness normally have less access to primary medical care.

• The burden of mental disorder is great. Economic and social hardship affect family and society.

• Mental and physical problems are interwoven.
• Integrated care ensure that people are treated in holistic manner, both physical and mental disorders. Chronic Illness and mental health

• The gap between actual patient and treatment receivers is enormous.
• Prevalence of mental disorder and people receiving treatment has a great difference.
• When mental health is integrated people can access mental health service closer to their homes.
• Help keeping their families together.
• Maintain daily activities normally.
• Long time monitoring and management.
• Mental health service delivered in integrated systems
• Minimize stigma and discrimination.
• Remove the risk of human rights violations (in psychiatric hospitals).
• Mental health care will be affordable and cost effective.
• Avoid cost for seeking specialist care in distant locations.
• Integrated care for mental health generates good treatment results when linked with network of service at secondary level. Chronic Illness and mental health

INTEGRATING BEHAVIORAL HEALTH TREATMENT INTO PRIMARY CARE SETTINGS

• Screening for psychiatric disorders gives an improved patient outcome.
• Without additional support, physician education results are minimal or short-lived.
• Collaborative care improves outcome for a wide range of primary care patients with psychiatric disorders.

INTEGRATING PHYSICAL HEALTH CARE INTO BEHAVIORAL HEALTH SETTINGS

• Screening for physical health conditions is necessary and it is to be followed by quality health care.
• Promise in reducing rate of chronic physical illness in people with severe mental illness.
• Primary care providers in  behavioral health care settings improve physical health outcomes.

  Barriers in interfere in integrating care

CLINICAL BARRIERS

• Difference in physical care and behavioral health cultures
• Lack of training.
• Providers lack of interest and stigma. Chronic Illness and mental health

ORGANIZATIONAL BARRIERS

• Difficulties in communication and consultation between physical and behavioral health providers.
• Physical separation of different provider types.
• Primary cares orientation to treating acute problems.

POLICY BARRIERS

• Legal obstacles for sharing information.
• Regulations limit the service organizations can provide.
• There are financial barriers.

Conclusion

• The conditions associated with long term mental illness include asthma, chronic obstructive airways disease (COPD), diabetes, coronary heart disease (CHD), arthritis, tumors and cancers, skin conditions including psoriasis and smoking related disease. Chronic Illness and mental health
• The fact that  depression and anxiety in the physically ill may go undetected and untreated merely stresses the importance of developing integrated services.
• To improve diagnosis, treatment and out comes, health care providers may find new ways to build partnership that create a more effective and collaborative practice that focus on patient centered whole body care.