It is well established that persons with a severe mental illness (SMI) have a greater risk of physical comorbid conditions and premature mortality. Most studies in the field of community mental health care (CMHC) have only focused on improving cardiovascular health in people with a SMI using lifestyle approaches. Studies using organizational modifications are rather scarce. This systematic review aimed to synthesize and describe possible organizational strategies to improve physical health for persons with a SMI in CMHC. The primary outcome was Health-related Quality of Life (HR-QOL). Results suggested modest effects on quality of life and were inconsistent throughout all the included studies. Despite these findings, it appears that a more integrated approach had a positive effect on health outcomes, patient satisfaction and HR-QOL. The complexity of the processes involved in community care delivery makes it difficult to compare different models and organizational approaches. Mental health nurses were identified as possible key professionals in care organization, but no clear description of their role was found. This review could provide new insights into contributing factors for integrated care. Future research targeting the identification of the nurses' role and facilitating factors in integrated care, in order to improve treatment and follow-up of somatic comorbidities, is recommended.

https://www.mdpi.com/1660-4601/18/2/462/pdf

Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life.

Abstract Issues Substance use disorders are associated with significant physical health comorbidities, necessitating an integrated treatment response. However, service fragmentation can preclude the management of physical health problems during addiction treatment. The aim of this systematic review was to synthesise the recommendations made by clinical practice guidelines for addressing the physical health of people attending alcohol and other drug (AOD) treatment. Approach An iterative search strategy of grey literature sources was conducted from September 2020 to February 2021 to identify clinical practice guidelines. Content pertaining to physical health care during AOD treatment was extracted. Quality of guidelines were appraised using the Appraisal of Guidelines Research and Evaluation II (AGREE‐II) tool. Findings Thirty‐three guidelines were included for review. Fourteen guidelines were considered high quality based on AGREE‐II scores. Neurological conditions (90.9%) and hepatitis (81.8%) were the most frequent health problems addressed. Most guidelines recommended establishing referral pathways to address physical health comorbidities (90.9%). Guidance on facilitating these referral pathways was less common (42.4%). Guidelines were inconsistent in their recommendations related to oral health, tobacco use, physical activity, nutrition and the use of standardised assessment tools. Implications and Conclusions Greater consistency and specificity in the recommendations made for integrating physical health care within addiction treatment is needed. Ensuring that recommendations are applicable to the AOD workforce and to treatment services limited by funding and resource constraints should enhance implementation. Future guideline development groups should consider increased consultation with the AOD workforce and inclusion of clinical tools and decision aids to facilitate referral pathways.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dar.13504

Systematic review of guidelines for managing physical health during treatment for substance use disorders: Implications for the alcohol and other drug workforce

Background: The main contributor to excess mortality in severe mental illness (SMI) is poor physical health. Causes include unfavorable health behaviors among people with SMI, stigmatization phenomena, as well as limited access to and utilization of physical health care. Patient centered interventions to promote the utilization of and access to existing physical health care facilities may be a pragmatic and cost-effective approach to improve health equity in this vulnerable and often neglected patient population. Objective/Methods: In this study, we systematically reviewed the international literature on such studies (sources: literature databases, trial-registries, grey literature). Empirical studies (quantitative, qualitative, and mixed methods) of interventions to improve the utilization of and access to medical health care for people with a SMI, were included. Results: We identified 38 studies, described in 51 study publications, and summarized them in terms of type, theoretical rationale, outcome measures, and study author’s interpretation of the intervention success. Conclusions: Useful interventions to promote the utilization of physical health care for people with a SMI exist, but still appear to be rare, or at least not supplemented by evaluation studies. The present review provides a map of the evidence and may serve as a starting point for further quantitative effectiveness evaluations of this promising type of behavioral intervention.

https://www.mdpi.com/1660-4601/20/1/126/pdf?version=1671797049

Interventions to Promote the Utilization of Physical Health Care for People with Severe Mental Illness: A Scoping Review

Patient Service Utilization Among Individuals with Co-occurring Disorders: A Comparison of Two Models of Care Coordination

Global pandemic, lockdown restrictions, and COVID-19 compulsory social isolation guidelines have raised unprecedented mental health in the sports community. The COVID-19 pandemic is found to affect the mental health of the population. In critical situations, health authorities and sports communities must identify their priorities and make plans to maintain athletes' health and athletic activities. Several aspects play an important role in prioritization and strategic planning, e.g., physical and mental health, distribution of resources, and short to long-term environmental considerations. To identify the psychological health of sportspeople and athletes due to the outbreak of COVID-19 has been reviewed in this research. This review article also analyzes the impact of COVID-19 on health mental in databases. The COVID-19 outbreak and quarantine would have a serious negative impact on the mental health of athletes. From the accessible sources, 80 research articles were selected and examined for this purpose such as Research Gate, PubMed, Google Scholar, Springer, Scopus, and Web of Science and based on the involvement for this study 14 research articles were accessed. This research has an intention on mental health issues in athletes due to the Pandemic. This report outlines the mental, emotional and behavioural consequences of COVID-19 home confinement. Further, research literature reported that due to the lack of required training, physical activity, practice sessions, and collaboration with teammates and coaching staff are the prime causes of mental health issues in athletes. The discussions also reviewed several pieces of literature which examined the impacts on sports and athletes, impacts on various countries, fundamental issues of mental health and the diagnosis for the sports person and athletes, and the afterlife of the COVID-19 pandemic for them. Because of the compulsory restrictions and guidelines of this COVID-19 eruption, the athletes of different sports and geographical regions are suffering from fewer psychological issues which were identified in this paper. Accordingly, the COVID-19 pandemic appears to negatively affect the mental health of the athletes with the prevalence and levels of anxiety and stress increasing, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population identified from this review. 

/pdf/impact-of-covid-19-outbreak-on-the-mental-health-in-sports-a-3k27yljk.pdf

Impact of COVID-19 outbreak on the mental health in sports: a review

A systematic scoping review of interventions to integrate physical and mental healthcare for people with serious mental illness and substance use disorders

Martin Burke

Papers

A systematic scoping review of interventions to integrate physical and mental healthcare for people with serious mental illness and substance use disorders