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Physical health care 

Physical health care
Physical health care

Tom Burns

, and Mike Firn

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date: 14 July 2020

This chapter deals with an increasingly important topic: the recognition that individuals with severe mental illness die nearly 20 years before they should. The situational factors contributing to this excess mortality are outlined—failure to register with a GP, homelessness, and dysfunctional help-seeking behaviour. Individual risks, including self-neglect, co-morbid conditions, and the impact of treatments (e.g. metabolic syndrome caused by novel antipsychotics), are also outlined. The role of the outreach worker can involve building liaison with the GP and, on occasions, taking direct responsibility for the physical care of some of the more severely ill patients. There are risks of blurred confidentiality, marginalization, and withdrawal by GP services in this approach, but sometimes it is inevitable.

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