For physicians and primary care doctors, treating patients who suffer from mental illness can be difficult. There is the fact that patients with mental health issues generally have more physical health problems than patients without. There are the side effects of prescribed mental health meds to deal with and coordination between the primary care physician and mental health specialists or emergency mental health care. Here is what you need to know as a physician or primary care doctor to help manage patients with serious mental illness.
Difficulties of Mentally ill Patients
The truth is, even for physicians and primary care doctors, dealing with mentally ill patients is just more difficult. Serious mental illnesses such as schizophrenia, nonaffective psychotic disorders, bipolar spectrum disorders, and others are diseases that affect over 13 million American adults.
Patients who suffer from these types of mental illness are at a higher risk of mortality from both clinical disease and unnatural causes such as suicide, homicide, or accidents. Along with these elevated mortality risks, there also comes more chance to suffer from more common medical conditions like metabolic disorders, cardiovascular disease, chronic pulmonary disease, gastrointestinal disorders, and obesity. Because patients with mental illness also exhibit high rates of nonadherence to treatment makes treatment even more challenging.
Mentally Ill Patients and Meds
As a physician or primary care doctor, you also have to be very aware of the medications your patients are taking to deal with their mental illness. Many of the meds come with an array of side effects that can be damaging to a patient’s physical health. For example, both first and second-generation antipsychotics have been linked with QT prolongation and second-generation antipsychotics can lead to obesity, hyperglycemia, diabetes, and hyperlipidemia.
In addition to the side effects of specific antipsychotic medications, many common medications that you may prescribe as a physician or primary care doctor can interact poorly with antipsychotics. When this happens, it can lead to all sorts of incredibly dangerous situations like cardiac arrhythmias, increased or decreased drug levels, toxicity, treatment failure, or even sudden death.
The Key to Caring for Mentally ill Patients
With all the difficulties that come with treating a mentally ill patient and all the things that could go wrong, how can physicians and primary care doctors provide better care for mentally ill patients? It is all about communication and collaboration. Unfortunately, psychiatrists and emergency mental health professionals and facilities do not currently do a good job working together to coordinate mentally ill patients’ care.
According to a recent survey, only around 33% of primary care doctors were notified when a patient of theirs goes to an emergency room or is discharged from a hospital. This is not a great stat especially when you look at a country like the Netherlands, for example, where that number is more than double.
The best course of action, as the American Psychiatric Association recommends, is for physicians and psychiatrists to work together to manage medical issues. This is easier said than done and might require additional permissions from the patient to share notes, lists of medications, and hospitalization data but it is well worth it to provide more holistic care for mentally ill patients which will lead to better long-term outcomes.
Until there is more teamwork across the healthcare industry that goes into caring for mentally ill patients, medical professionals in every field will struggle to provide the best care possible. Yes, there are a lot of challenges and roadblocks associated with doing this but the rewards for the patients are great. As a physician or primary care doctor, it is time to take the lead and start a conversation with mentally ill patients about collaborative care.