Identifying Barriers to Improving the Wellness of Persons With Severe Mental Illness in Community Residential Mental Health Facilities

Abstract

Persons with severe mental illness are at increased risk of suffering from severe physical illnesses. Health promotion programs focusing on improving the quality of nutrition and physical activities are especially important for this population. However, attempts to advance the quality of these wellness components may encounter difficulties within the context of community residential mental health facilities. To identify barriers to wellness, a qualitative study was conducted in Israel with 84 persons with severe mental illness who lived in these facilities and who participated in a health promotion program in a psychiatric hospital. The findings illuminate that this population may face some unique biological–social barriers, in addition to the psychological effects of their mental illness, that hamper the advancement of their wellness. The barriers may include the side effects of medications and/or the results of lack of companionship. In addition, organizational and broader systemic barriers, such as organizational culture and policies that do not support the advancement of wellness, may contribute to an accumulation of barriers. The eco-systemic perspective could be useful in identifying biological–psychological–social–organizational and broader systemic barriers to the advancement of wellness as well as areas needing to be strengthened or developed in order to support the advancement of wellness.

Keywords:

• health promotion programs
• wellness
• mental illness
• barriers
• nutrition
• physical activity

Acknowledgments

This research was supported by the Israel National Institute of Health Policy and Health Services Research. The authors thank Charlene Drobny for her significant contribution to this article.