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The livid 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

The livid 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
The livid 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
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: 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.
1471-244X
C., Carswell
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J.V.E., Brown
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R.A., Ajjan
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S.L., Alderson
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A., Balogun-Katung
796e8da3-20ca-4a69-a69b-1048c7d3bee6
S., Bellass
f5ca4fe7-aea8-49dc-a1a6-d3c151c45fd6
K., Double
187a9d83-e397-4dbc-bbdf-6c8d46148865
S., Gilbody
51192a31-3174-4450-8755-50098409b008
C.E., Hewitt
912ce5cc-90b0-4788-b33e-cdc9a2fe8262
R., Jacobs
866d8f3e-c1e0-46b7-888a-35d6000e78a5
Holt, Richard
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I., Kellar
24e26393-8783-40d3-ab44-119af97dce62
E., Peckham
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D., Shiers
cda9a572-de4d-4be6-82cb-491d3e8bca6c
J., Taylor
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N., Siddiqi
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P., Coventry
5b5dfee8-ad0a-4f19-a4cc-4058328f98ec
DIAMONDS Research Team
C., Carswell
d6b65238-ebc0-40dd-b297-05aea78c7289
J.V.E., Brown
62f77248-f330-49f2-b55f-9c736b08b789
R.A., Ajjan
2b92e62b-fb4d-475f-8df5-3cfaa8b876f2
S.L., Alderson
627b4814-337c-4f6a-9e8d-040d982fd156
A., Balogun-Katung
796e8da3-20ca-4a69-a69b-1048c7d3bee6
S., Bellass
f5ca4fe7-aea8-49dc-a1a6-d3c151c45fd6
K., Double
187a9d83-e397-4dbc-bbdf-6c8d46148865
S., Gilbody
51192a31-3174-4450-8755-50098409b008
C.E., Hewitt
912ce5cc-90b0-4788-b33e-cdc9a2fe8262
R., Jacobs
866d8f3e-c1e0-46b7-888a-35d6000e78a5
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
I., Kellar
24e26393-8783-40d3-ab44-119af97dce62
E., Peckham
c4843e9a-4fe0-46c9-bbf2-a016e5f1581f
D., Shiers
cda9a572-de4d-4be6-82cb-491d3e8bca6c
J., Taylor
89d4e33a-fe0a-4e17-9662-7dc69c43b619
N., Siddiqi
b6951748-13a0-4edf-a9ed-27ba08f7e44d
P., Coventry
5b5dfee8-ad0a-4f19-a4cc-4058328f98ec

C., Carswell, J.V.E., Brown and R.A., Ajjan , DIAMONDS Research Team (2022) The livid 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. BMC Psychiatry, 22. (doi:10.1186/s12888-022-04117-5).

Record type: Article

Abstract

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: 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.

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e-pub ahead of print date: 19 July 2022

Identifiers

Local EPrints ID: 468283
URI: http://eprints.soton.ac.uk/id/eprint/468283
ISSN: 1471-244X
PURE UUID: f3c9dd86-bf53-4eba-9762-cbe41c358d2a
ORCID for Richard Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 09 Aug 2022 16:46
Last modified: 10 Aug 2022 01:37

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Contributors

Author: Carswell C.
Author: Brown J.V.E.
Author: Ajjan R.A.
Author: Alderson S.L.
Author: Balogun-Katung A.
Author: Bellass S.
Author: Double K.
Author: Gilbody S.
Author: Hewitt C.E.
Author: Jacobs R.
Author: Richard Holt ORCID iD
Author: Kellar I.
Author: Peckham E.
Author: Shiers D.
Author: Taylor J.
Author: Siddiqi N.
Author: Coventry P.
Corporate Author: DIAMONDS Research Team

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