Addressing Physical Health Needs of Mental Health Patients by Nurses

This essay explores the multifaceted ways nurses address the physical health needs of individuals with mental health problems. It delves into studies that highlight the discrepancies in physical wellness among this population, emphasizing the importance of integrated care. The essay discusses key elements such as interdepartmental collaboration, compatible information systems, and the need for ongoing research to identify patient needs. It also examines the role of mental health nurses in providing physical health care, noting the challenges of knowledge gaps, poor communication, and role ambiguity. Furthermore, the essay outlines practical interventions nurses can implement, including weight management programs, promoting physical activity, reducing substance abuse, and providing dental care. Ultimately, it underscores the necessity of continuous professional development and collaborative partnerships to improve the overall health outcomes for people with mental illnesses. Desklib provides access to similar essays and resources for students.

How nurses address the physical health needs of people with mental health problems.
Introduction.
Being physically healthy is being free of injury or any illness (Malani 2012, pp.1813-1814).
This includes dental health, sleeping well, having good personal hygiene, eating a healthy and
balanced diet and having a weight that is healthy. The physical health state of an individual
may affect his or her mental health in one way or the other (Jorm 2012 p. 231). The mental
health of an individual entails being well psychologically without any mental illness. The
individual must function in a satisfactory manner in relation to behavior and his emotions.
Individuals with mental illnesses are always at a higher risk of having some of the chronic
conditions. These people with mental illnesses may lack the motivation to seek health
services to address their issues due to the impact of these mental conditions on their social
and cognitive functions. I conducted my search by looking into the studies that have been
conducted in various countries or places that assess how the nurses respond to or address the
physical health needs to the individuals with mental health illnesses and also how they
worked in this particular setup in the care delivery. Part of the search was the factors that
affected their service delivery of physical needs to these individuals. By looking into the
results of the study, one can get an overview of how nurses address and should address
physical health needs to individuals with mental illnesses.
Studies related to the subject matter.
According to Rodgers (2018), individuals with mental health illnesses tend to have poor
physical wellness leading to a low life expectancy. There is evidence that suggests that the
discrepancy is driven by combining factors like health system factors and socioeconomic
factors not leaving the absence of integration when the care is needed across the service

setting. The mental and physical well-being of an individual is closely linked and it requires
delivery of care and treatment to address both issues. In this study, some elements were
identified that help the nurses in the wholesome management of these individuals and they
included;
Liaising with other departments. The two departments that are there are mental health and
physical health departments should work together in providing care for the patients in their
mental health setups. Some patients may be admitted to mental health problems. The nurse
should be responsible enough to identify the patient and provide appropriate care (Stuart
2014). The location of these services should be close. The mental health specialist must
always be found in a medical ward to collaborate and work willingly together. Structural
systems should be done for success in the integration of care for these people. Compatible
information systems within and across the different organizations that are involved in the care
delivery of the patients. This will allow the identification and tracking of physical health
needs of the patients by the care provider. It is achieved by use of electronic medical records
of the patients. Research should also be done to identify the patients’ needs. There is a need
to improve communication between the caregivers and the information technology to support
and clarify the people responsible for physical health care for people with mental illnesses
(Dixon et.al 2016, pp.13-20).
In a study to assess the role of mental health nurses in providing physical health needs to
patients with mental health problems, it was found that these individuals with mental illnesses
have poorer physical health when you compare them with the general populations (Liu et.al
2017, pp.30-40). This study was conducted in a forensic inpatient facility. There was a lack
of knowledge in relation to physical health care among the nurses as there are only mental
health nurses that were working in the facility. The nurses reported that there was no formal

training even though a good number of them were willing to go through the training although
they also reported that there was lack of support from the management in undertaking the
training. Some of the physical conditions were the diabetes of which they had no experience
in care delivery. Poor communication among the caregivers was noted. In this study, primary
health care providers screened the patients for physical health but they had no knowledge of
mental illnesses. This acted as a barrier in communicating the findings to secondary
caregivers. The patients felt comfortable when screened by secondary caregivers as opposed
to the primary caregivers as poor communication between the two groups was a barrier to
having effective interventions to the patients. A program was started to make efforts in
enabling mental health nurses in assessing and acting on the physical health needs of people
with serious mental illnesses. This set registers for individuals with serious mental illnesses,
health promotion, advice and weight management. This was made more accessible to all
patients. Upon evaluation of this program, positive results were found in the identification of
physical health abnormalities that the nurses might not have noted when caring for mental
illnesses. Role ambiguity was also noted. Nurses lacked the need to expand their traditional
focus on mental health illnesses alone. They received no training on how to respond to the
physical health needs of the patients. This led to the poor therapeutic relationship with the
patients, the carers and the family members. Patients reported that they put forward their
physical health needs on the mental settings and were not addressed. This study suggests
giving the mental health nurses appropriate and proper training and support on the physical
health needs and this could have good outcomes on the patients.
In another study, nurses reported having always checked their patients if they had any
physical health issues during the initial assessment. This helped in coming up with a nursing
care plan that addressed the needs. They also did everyday monitoring of blood pressure and
also assisted the patients in their personal hygiene. Nurses in Hong Kong were more involved

in the patients’ physical care that the nurses in Qatar and Japan. The nurses also ensured that
the mentally ill individuals were registered to a family doctor. Weighing of patients was done
on a regular basis to check for healthy weight. Weight can also be an indication of physical
illness in a case where the individual is obese or has malnutrition. Nurses provided health
promotion advice that included regular exercises, a regular dental check-up for their dental
health, stopping of drug and substance abuse like tobacco and smoking, eating healthy food
and the help with weight management. This involvement of the nurses in addressing the
physical health needs of the individuals varied in different countries. This study also looked
into the attitude of nurses toward the involvement in the physical health care of individuals
with serious mental illnesses and there was a slightly favorable attitude with most of the
nurses helping the patients in nutrition advice and other aspects of physical health. Nurses in
thein the United States of America and the United Kingdom reported that mental illness was
being a barrier to providing and improving the physical health needs as even the patients
themselves lacked the motivation to seek health services. Reports found that most physical
issues for the patients were due to their worry about their mental statuses. Lack of confidence
was reported among the Japanese nurses in delivering all aspects of physical care to these
patients especially those that had diabetic foot ulcers and cancer patients. Big workloads were
one of the barriers identified that prevented the nurses in the engagement of physical health
promotion. More than half of the study participants felt the need for information and training
pertaining to physical health especially diabetes management and cardiovascular health
issues. Resources and time should be provided to the staff to integrate the physical and
mental health problems for effective service delivery not forgetting the empowerment of the
nursing and other clinicians for competence in their care.
Areas of importance and action for a nurse to improve the outcomes of people with mental
illnesses. The most significant being diabetes and cardiovascular conditions. The mental

health nurse should work in partnership with other professionals. Connections on referral
system should be clear to make it easier in the transition of the patient from one service to
another within the hospital, the community, the social caregiver, the mental specialist, and the
other community services with proper guidance and support. An example in collaborating
with the pharmacy and the community to focus on issues like drug and substance abuse like
smoking, health education like reproductive health. Some facilities have support systems like
working with the physical health providers by having meetings that enhance sharing of
information and learning. Knowledge and skills are also two things that are required out of
the mental health nurse. During the assessment, the nurse should ensure to recognize patients'
physical, social and psychological needs and respond to them promptly. Opportunities to
continue with nursing profession development is needed to have the knowledge and skills
that are required to conduct the activities for them to be competent enough. Some of the
activities the nurses do to address the physical health needs include;
Tackling obesity. Individuals that suffer from mental illnesses have a high tendency of
fluctuating weight that may lead to obesity or malnourishment that is brought by anorexia
which is an effect of the medications used to treat the mental disorders. This causes an
increased risk of physical health problems among patients with mental illnesses. In this,
nurses have weight management programs that help individuals to reduce their intake and
focus on physical fitness. With being physically fit, it means that the person has reduced the
chances of having conditions that are associated with obesity like hypertension, heart
diseases, and even diabetes. Eating a balanced healthy diet also helps individuals in
maintaining a healthy body. Interventions on diet like diet modification considering involving
the family, the culture and belief of the individual and the nurse’s goal in this.
Improving the physical and activity levels of the people. Lack of physical activities may
bring about diabetes, being obese, it can cause depression and lead to muscle wastage. The

nurse should encourage the individual to carry out in a defined activity by the doctor in a day
or week. The nurse can also engage the community or work with local partners to ensure that
the patients are able to access sports centres, the gym and other leisure activities that will be
available.
Reduction of alcohol and substance use. Individuals with mental problems tend to abuse
alcohol more than the general population and neglect their physical health (Kieres-
Salomoński et.al 2015, pp.265-275). Alcohol may interact with the drugs used in mental
health treatment and this can threaten the person's life. Prolonged use of drugs like cocaine
causes seizures and even cause physical health problems like lack of sleep and loss of weight.
Nurses build a trusting and non-judgemental relationship with these patients the first time
they meet. They take part in the screening of individuals for alcohol use disorders and make
appropriate interventions. Giving verbally and written the information about the effects of the
use of drugs on their mental health and even on the prescribed medicines, they use. The use
of local substance abuse services and groups can be of help to the people. The nurse should
have a knowledge of how to manage the physical emergencies that are associated with
substance abuse like seizures and opiate overdose. In the management, the nurse should use
the protocol in the assessment and initiating substitute or detoxifying.
Provision of dental and oral health care. People with mental health problems most often
forget to observe dental and oral hygiene and the dental services in their facilities are not
utilized well. Most of these patients lose their teeth due to poor oral hygiene. Substance use
may also lead to loss of teeth. In the first assessment of the patient, the nurse should include
dental assessment and oral. Ensuring that the patients have access to dental equipment like
toothbrush and paste might act as a motivating factor for the patients to take part in their own
dental hygiene. Always encourage people to quit smoking as this has a great effect on their

teeth. Advising people to take foods that are less sugary and also carbonated drinks. Patients
should be advised to brush their teeth twice in a day using clean water and a fluoride paste.
Supporting individuals to quit smoking. This is the most effective intervention that helps to
reduce physical illness and mental illness too. It is difficult for an individual to stop smoking
by themselves hence the help of the nurse is needed. Stopping smoking helps the patient in
reducing anxiety and depression. The nurse should always ask the people if they smoked
because most of the time people tend to hide their smoking behaviors. Always support the
individuals who have wished to cut down on their smoking and help the access the smoking
cessation group. The nurse should have the skills and the confidence she needs to administer
nicotine therapy for the people. Offering advice to the individuals and encouraging them to
quit smoking and also informing them of the effects of smoking on their physical and mental
health. Support for the individuals when they have smoking withdrawal syndromes is
necessary because if left that way, it may negatively impact their health and may injure
themselves. Engagement with the local cessation services to plan and deliver community
activities for individuals suffering from mental health problems.
Medicine use and optimization. Medicines are the primary treatment for most mental health
illnesses. They are always in combination with social and psychological interventions.
Correct consumption of these medicines increases the chances of getting better. In relation to
this, the nurse must be aware of the medicines the person is taking for the mental illness and
even the physical problems. Understanding the indications for each medicine, their drug
interactions and side effects of the drugs is important. Dosages for the drugs should be well
calculated and the use of the right route of administration. Always collaborate with the
pharmacy on new drugs issued in case of uncertainties. As a nurse, you should always ask
your patients about the effects of the drugs they take on a regular basis. Being an advocate of

the patient for any medicine change or stop of use of a particular drug.
In another angle, nurses address the physical health needs by using integrated care for
physical health and mental health needs as discussed earlier. Another important issue is
stigmatization that is related to mental health. Stigma and discrimination have very severe
consequences than even having physical or mental illnesses. The health professionals that
work in the mental health facilities have a negative perception of mental health illnesses. This
may lead them to shy off from working with individuals that they may think are confused or
complex. The use of systems that deal with physical health problems to cater for
appointments of patients acts as a barrier for patients suffering from severe mental illnesses
because they already have existing cognitive impairments to remembering. They may also
have anxiety to attend to new services. These group of patients may feel like they are not
understood and accepted in society. Nurses should work on their attitudes towards the
patients and focus on the various interventions they can put in place to reduce the stigma.
Another study was conducted to identify and address sexual health to individuals having
mental health illnesses. Sex is also an important issue to address in the people suffering from
mental illnesses. These individuals also have sex needs although these needs are poorly
addressed by the health, in particular, the nurses though it is a complex issue. Mental health
nurses are aware of the sexual needs of patients. Providing sexual health or education is
neglected by nurses. There is a need for the staff to develop a workforce that will incorporate
sexual health to the patients. This can be achieved by introducing discussion groups in
relation to sexual health. This will help the nurse in planning the care for this particular
patient.

Inclusion of sexual health when assessing the patient and evaluating their level of
understanding of sexual matters. Support your women patients with their mental problems to
reduce the incidence of unintended pregnancies and make them aware of the methods
available for contraception in your facility.

References
Bressington, D., Badnapurkar, A., Inoue, S., Ma, H., Chien, W., Nelson, D. and Gray, R.,
2018. Physical health care for people with severe mental illness: The attitudes,
practices, and training needs of nurses in three Asian countries. International journal
of environmental research and public health, 15(2), p.343.
Dixon, L.B., Holoshitz, Y. and Nossel, I., 2016. Treatment engagement of individuals
experiencing mental illness: review and update. World Psychiatry, 15(1), pp.13-20.
Jorm, A. F. (2012). Mental health literacy: empowering the community to take action for
better mental health. American psychologist, 67(3), 231.
Kieres-Salomoński, I. and Wojnar, M., 2015. Comorbidity of alcohol dependence with other
psychiatric disorders. Part I. Epidemiology of dual diagnosis. Psychiatr. Pol, 49(2),
pp.265-275.
Liu, N.H., Daumit, G.L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., Druss, B., Dudek, K.,
Freeman, M., Fujii, C. and Gaebel, W., 2017. Excess mortality in persons with severe
mental disorders: a multilevel intervention framework and priorities for clinical
practice, policy and research agendas. World psychiatry, 16(1), pp.30-40.
Malani, P.N., 2012. Harrison’s principles of internal medicine. JAMA, 308(17), pp.1813-
1814.
Rodgers, M., Dalton, J., Harden, M., Street, A., Parker, G. and Eastwood, A., 2016.
Integrated care to address the physical health needs of people with severe mental
illness: a rapid review.
Stuart, G.W., 2014. Principles and practice of psychiatric nursing-e-book. Elsevier Health
Sciences.

appendix
Database
Searched
Data searched Search strategy
used
(Keywords,
phrases, subject
matter)
Limits
(Data
range,
language)
No.
Results
Notes
Search strategy saved (name)?
Files saved/exported(name
/place)
Keywords, authors for future
searches
I used an
internet
database,
review of
previous
studies in
relation to the
topic.
How to address
the physical
health needs of
persons with
mental health
illnesses
Factors that affect
care delivery to
mentally ill
people in relation
to their physical
needs.
Severe mental
illness, physical
health needs
Range of 5
years
The
language
was English
5 Files saved include a document
titled “improving the physical
health for people with mental
health problems” to word.
Integrated care to address the
physical health needs of people
with severe mental illness.
Authors include Mark Rodgers,
Jane Dalton, Melissa Harden,
Andrew Street, Daniel
Bressington, Ashish
Badnapurkar and many more