Key result
Organizational strategies using an integrated approach showed modest but inconsistent positive effects on health-related quality of life in persons with severe mental illness.
Why the study?
Most community mental health care studies focus on lifestyle approaches for cardiovascular health in severe mental illness, leaving organizational modifications scarce.
Do organizational strategies improve health-related quality of life in persons with severe mental illness and comorbid somatic conditions in community mental health care?
Systematic Review
Do organizational strategies improve health-related quality of life in persons with severe mental illness and comorbid somatic conditions in community mental health care?
Integrated organizational approaches in community mental health care may modestly improve health-related quality of life and somatic outcomes for patients with severe mental illness.
Integrated strategies may yield modest HRQoL gains in severe mental illness; leaves open need for consistent, standardized trials before broader adoption.
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.
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Martens et al. (2021) conducted a systematic review in Severe mental illness (SMI) and comorbid somatic conditions. Organizational strategies and integrated care approaches was evaluated on Health-related Quality of Life (HR-QOL). Organizational strategies using an integrated approach showed modest but inconsistent positive effects on health-related quality of life in persons with severe mental illness.