The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions

TY - JOUR

T1 - The lived experience of severe mental illness and long-term conditions

T2 - a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions

AU - Carswell, Claire

AU - Brown, Jennifer Valeska Elli

AU - Lister, Jennie Elizabeth

AU - Ajjan, R.A

AU - Alderson, S.L

AU - Balogun-Katung, S

AU - Bellass, Sue

AU - Double, K

AU - Gilbody, Simon

AU - Hewitt, Catherine Elizabeth

AU - Holt, Richard I G

AU - Jacobs, Rowena

AU - Kellar, I

AU - Peckham, Emily Jane

AU - Shiers, David

AU - Taylor, Jo

AU - Siddiqi, Najma

AU - Coventry, Peter

N1 - © The Author(s) 2022.

PY - 2022/7/19

Y1 - 2022/7/19

N2 - BACKGROUND: People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals.METHODS: A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically.RESULTS: Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs.CONCLUSION: The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.

AB - BACKGROUND: People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals.METHODS: A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically.RESULTS: Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs.CONCLUSION: The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.

KW - Caregivers

KW - Delivery of Health Care

KW - Health Personnel

KW - Humans

KW - Mental Disorders/complications

KW - Qualitative Research

KW - Self-Management

U2 - 10.1186/s12888-022-04117-5

DO - 10.1186/s12888-022-04117-5

M3 - Article

C2 - 35850709

SN - 1471-244X

VL - 22

JO - BMC Psychiatry

JF - BMC Psychiatry

IS - 1

M1 - 479

ER -