title: Barriers to metabolic care for adults with serious mental illness: provider perspectives.
abstract: This study assessed barriers to metabolic care for persons with serious mental illness (SMI) by surveying experienced healthcare providers. Sixty-eight medical, mental health, and other stakeholders who care for patients with SMI attended a CME conference focused on medical management of SMI patients in 2007. They completed a 27-item survey assessing barriers to and systemic responsibility for metabolic care. The top three ranked barriers were: "separate mental health and primary care systems," "patient's lack of resources," and "[mental health] providers are not trained to do basic primary care." Results indicated that ratings of CMHC responsibility for SMI metabolic care (M = 5.2, SD = 1.5) were significantly lower than ratings of public health (M = 5.7, SD = 1.4), t(66) = 2.3, p = 0.027, and primary care providers (M = 6.3, SD = 1.1), t(67) = 4.7,p <0.001. Experienced providers identified a lack of integrated care and patient characteristics as important barriers to metabolic care and concluded that the primary care and public health systems are primarily responsible for metabolic treatment.
authors.affiliation: University of Washington School of Medicine, Seattle, USA. mikemcd@uw.edu
authors.forename: Michael G
authors.initials: MG
authors.lastname: McDonell
authors.forename: Erin A
authors.initials: EA
authors.lastname: Kaufman
authors.forename: Debra S
authors.initials: DS
authors.lastname: Srebnik
authors.forename: Paul S
authors.initials: PS
authors.lastname: Ciechanowski
authors.forename: Richard K
authors.initials: RK
authors.lastname: Ries
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003155:Community Mental Health Centers; D015897:Comorbidity; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D010348:Patient Care Team; D010819:Physician's Role; D011320:Primary Health Care; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents