Sometimes people who experience mental health issues have trouble getting proper care for physical health problems. In this research, consumers refused to accept this situation, and talked about the strategies they used to get good physical health care.
Ewart, S. B., Bocking, J., Happell, B., Platania-Phung, C., & Stanton, R. (2016). Mental health consumer experiences and strategies when seeking physical health care: A focus group study. Global Qualitative Nursing Research, 3. doi:10.1177/2333393616631679
People who live with mental health challenges have more physical health problems than other Australians, and have a lower life expectancy. There are a lot of different reasons for this, including impacts of medication, but one important reason is that people living with mental health challenges often do not get the same level of physical health care that other people do. Australian consumer researchers did focus groups with 31 consumers to find out about their experiences in using health services for their physical health needs.
Consumers described how having a diagnosis of mental illness was a major barrier to communicating with health professionals about their physical issues. Many felt that when health professionals knew about the mental health issues, they focused on assessing and treating that and dismissed the physical problems.
“[Rather than] ‘we need to get you on a diet… we need to get you on that plan’… it’s first ‘how’s your mental health? Are you okay? Stick to these drugs, you’ll be fine.’”
Sometimes health professionals also did not take notice of what the consumer said that they needed, thinking that they knew better.
“I’m here because I have made an informed choice, involving self-determination that I know will benefit both my mental and physical health and you’ve just told me that it won’t. That’s so disheartening. That’s so disempowering.”
While consumers respected the knowledge of health professionals, they thought that they were the experts on themselves and this should be acknowledged by health professionals.
“I feel like there needs to be a shift in power. So instead of me going to the expert an begin told what to do, and me thinking that’s going to cure myself. I want to be – I know myself better than anyone does.”
Some people felt that they could not get attention for their physical concerns until there was a crisis:
“It works backwards. You go to the crisis, and then you get the help. And you don’t get the help if you present without a crisis.”
Bad experiences with health providers made consumers feel hopeless, with “nowhere to turn to” and discouraged them from seeking help for physical problems. Not getting the help that they needed was bad for both their physical and mental health.
This was not the case for everyone, however, and finding a health provider who would listen and address physical concerns was seen as critical. When consumers found such a person, they felt very lucky and saw the relationship as precious.
“They need to believe the client. You’re not making things up and they can check for themselves and see, you know. If I find a good doctor, I hang onto them.”
Consumers sometimes had to be persistent to find the right health care provider.
In the future, consumers hoped that more health professionals would change their attitudes and provide better physical health services to mental health consumers. However, in the meantime they had developed some strategies to help them get the care they needed.
Some talked about preparing for the health care interaction by finding out information beforehand:
“I actually google symptoms. So I have the right language to use when with the doctor. That’s one of the strategies that I use.”
Others felt that it was important to not allow the doctor to rush them to fit in the “10 minute window”:
“It’s taken me a long time to have the courage to say, ‘Well hang on a minute. I need help with this. Can you refer me to these other services?’… and say ‘Well, this is what’s helping, and this is what’s not helping’.”
Some felt that they got better attention for their physical problems if they “just don’t tell them” about certain aspects of their mental health.
Consumers regularly talked about the importance of questioning health professionals and not taking their word as “gospel”. They also felt that they needed to be assertive and not accept bad treatment.
“Well doctors aren’t gods and you should question them and if you find a good doctor, hang on to them, and the other ones I think you should report them… Yeah, I reported them, there was an investigation.”
“I had to learn how to choose to see another doctor”.
While consumers did not often discuss the issue of physical health care providers with each other, when they did this was useful. Other consumers were a good resource for finding out names of good, consumer-friendly health care providers in the area.
Participants also thought that there were great potential for involving other people with lived experience, especially peer workers, in physical health activities. The ways that peer workers were thought to be able to help were:
- Giving health promotion information
- Advocating with health professionals
- Helping with motivation to do healthy activities
- Accompanying the person to the gym or a pool or for a walk
- Social support and empathy
- Explaining how to make complaints about bad experiences
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