Physical health care for people with severe mental illness: The role of the general practitioner (GP)

Abstract

Objectives : Severely mentally ill people have high levels of mortality and physical morbidity. As greater numbers of people with severe mental illness have moved into community accommodation, responsibility for their physical health needs is often unclear. This study investigates whether patients receive better physical health treatment if they attend their GP, a Community Mental Health Team, or both. Design : Five hundred and sixty-six representative annual period prevalence cases of psychotic disorders were ascertained in a case identification exercise in South London and 309 were randomly selected for interview. The information sought included details of their physical health problems, the physical health treatment they received and their pattern of service use. Setting : Two south London community psychiatry catchment areas. Results : Patients who had seen their GP in the previous 6 months were more likely to be satisfied with the amount ( p =0.014) and type ( p =0.16) of service provided for their physical health. Only 7% reported unmet physical needs and 75 % reported that they received the right type of help. Contact with any member of their community mental health team or with none did not affect the patient's report of their physical health care. Conclusions : All patients with a psychotic disorder should be registered with a GP. It should be clear to all involved that the GP is responsible for physical health service provision. There is a strong argument for a routine annual check up of the severely mentally ill by their GPs.