Serious Mental Illness

Healthcare for Those with Serious Mental Illness

Authors: Colline Wong, Christopher Steele MD MPH

Introduction

More than 50% of Americans will be diagnosed with a mental illness, such as anxiety or depression, at some point in their lifetime.1 A serious mental illness is a mental, behavior, or emotional disorder resulting in serious functional impairment; the most common conditions classified as SMI are schizophrenia, bipolar disorder, major depressive disorder and posttraumatic stress disorder. Approximately 1 in 25 of Americans live with a serious mental illness.1 This population has been estimated to have a life expectancy that is 20-25 years lower than those without mental illness! 

There are many factors that contribute to a possible explanation for this increased mortality. Patients with serious mental illness have worse medical health outcomes for common diseases such as hypertension, diabetes and heart disease when compared to those who do not have a diagnosed mental illness.2  As a whole, those with serious mental illness also have higher rates of suicide, smoking, alcohol and illicit drug use and an increased risk of infectious and blood borne diseases.3  Furtmore, this population faces stigmatization that may lead to them either fearing or having a lack of awareness to seek appropriate care. Finally, there is a national shortage of providers who manage psychiatric illness, especially for those without insurance or on Medicaid.

While there is a broad range of psychiatric disorders that cause varying levels of dysfunction in people’s daily lives, serious mental illness can be debilitating. Patients may have difficulty maintaining relationships, completing their education/training, and keeping a job. This frequently leads to those with serious mental illness to have a lower socioeconomic status, thus having issues accessing housing, resources and health care.  In 2016, more than a quarter of adults who experienced serious psychological distress reported an unmet need for mental health care, and 41.3% of these people did not receive mental health treatment because they could not afford it.4 

This session will focus on mental health, with a specific focus on the seriously mentally ill population. As future healthcare providers, we need to recognize that patients with psychiatric disorders will be seen in all clinics, regardless of specialty. Learning how to adapt our clinical encounters and treatment plans to accommodate the needs of a patient with a psychiatric disorder will be a necessary skill for every health care worker.

 

Learning Objectives

By the end of the session, students will be able to:

  • Define mental illness and serious mental illness.
  • List and describe the basic demographics of psychiatric disorders in the United States and the state of Connecticut.
  • Explain the major barriers to accessing health care services for individuals with serious mental illness.
  • Identify the medical comorbidities that those with serious mental illness have an increased risk for.
  • Apply techniques to find mental health services and primary care services for patients in your local area.

 

Required Assignments

  1. Wong, C. Introduction to Healthcare for those with Serious Mental Illness:
    https://www.youtube.com/watch?v=oEGonmwKXJw 
  2. Wong, C. Addressing Health Care Needs for those with Serious Mental Illness:
    https://www.youtube.com/watch?v=lj3y0sE85gg 
  3. NIMH Mental Illness. Nimh.nih.gov.
    https://www.nimh.nih.gov/health/statistics/mental-illness#part_154788. Published 2021. Accessed June 14, 2021.  
  4. Barnett B. Out Of Options For Patients With Serious Mental Illness. HealthAffairs; 2021.
    https://www.healthaffairs.org/do/10.1377/hp20210114.165591/full/ . Accessed June 12, 2021. 
  5. Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CI. Serious mental illness and medical comorbidities: Findings from an integrated health care system. J Psychosom Res. 2017;100:35-45. doi:10.1016/j.jpsychores.2017.07.004 
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576509/

 

Optional Assignments

  1. The Cost of Mental Illness: Connecticut Facts and Figures, Leonard D. Schaeffer Center for Health Policy and Economics, http://ctnonprofitalliance.org/wp-content/uploads/2016/12/CT-Chartbook_final.pdf.
  2. Saks E. A Tale of Mental Illness-From the Inside. Presented at TedGlobal2012; June 2012; Edinburgh, Ecotland.https://www.ted.com/talks/elyn_saks_a_tale_of_mental_illness_from_the_inside?language=en#t-2262. Accessed June 10, 2021. https://www.ted.com/talks/elyn_saks_a_tale_of_mental_illness_from_the_inside?language=en#t-2262

 

Works Cited

  1. “Learn About Mental Health - Mental Health - CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 Jan. 2018, https://www.cdc.gov/mentalhealth/learn/index.htm.
  2. Rosenbaum L. Unlearning our Helplessness- Coexisting Serious Mental and Medical illness N Engl J Med 357;17 Oct 27,2016
  3. Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CI. Serious mental illness and medical comorbidities: Findings from an integrated health care system. J Psychosom Res. 2017;100:35-45. doi:10.1016/j.jpsychores.2017.07.004
  4. The Cost of Mental Illness: Connecticut Facts and Figures, Leonard D. Schaeffer Center for Health Policy and Economics, http://ctnonprofitalliance.org/wp-content/uploads/2016/12/CT-Chartbook_final.pdf.