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Reasons cited for the importance of CHD screening in SMI | CMHT | GP | SU | N |
• There is a high prevalence of smoking and weight problems among their own caseload with SMI |
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![]() | 23 | |
• Physical health is often neglected by services due to their focus on clients' mental health problems |
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![]() | 20 |
• Side effects of antipsychotics, e.g. weight gain and metabolic |
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![]() | 14 |
• Physical health can be neglected due to clients' poor motivation and social isolation – they need extra help and encouragement with this |
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![]() | 13 |
• Research evidence indicates people with SMI are a high risk group for CHD |
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![]() | 9 | |
• Knowing about one's personal risk for CHD would enable clients to take timely preventative action (e.g. to make lifestyle changes) |
![]() | 8 | ||
• Regular screening would allay client's fears about their physical health |
![]() | 7 | ||
• Clients are aware of their own risk factors for CHD, especially smoking, family history, diet and weight |
![]() | 6 | ||
• Screening should be offered to everyone, regardless of SMI diagnosis |
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![]() | 3 |
• Recent experience of clients with SMI dying due to undetected CHD |
![]() | 2 | ||
• The stress of having SMI may adversely affect the heart |
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![]() | 2 | |
• People with SMI are harder to engage and so need more assertive screening |
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• It is important for staff to recognise risk and be able to interpret any new physical symptoms as organic rather than psychological in nature |
![]() | 1 | ||
Perceived obstacles to/negative views of CHD screening | ||||
• Lack of appropriate resources in existing services – e.g. time, trained staff |
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![]() | 18 | |
• Anticipation of low uptake rates by patients with SMI |
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![]() | 17 | |
• Perceived difficulty in making lifestyle changes amongst people with SMI, even if risk CHD factors are identified |
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![]() | 15 |
• Patients dislike having blood tests |
![]() | 12 | ||
• Lack of funding for CHD screening services or it not being seen as a priority by Trust management |
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![]() | 12 |
• A screening offer might be viewed as interference in patients' lives – they may feel defensive, anxious or paranoid |
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![]() | 7 | |
• Stigma: a perception that services such as smoking cessation can't deal with people with SMI |
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![]() | 4 |
• CMHT services already "squeezed" |
![]() | 4 | ||
• Staff resistance to more changes in their role – CHD screening would be moving too far away from their mental health role |
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• Poor communication of results between primary and secondary care |
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![]() | 3 | |
• Lack of appropriate services to refer patients to if risk factors are identified – e.g. long waiting lists, narrow referral criteria, group sessions |
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• It would not be cost effective to screen all SMI patients, only those in high risk groups e.g. overweight |
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![]() | 2 | |
• Prior experience of low attendance when routine screening appointments were offered to people with SMI in line with the new GP contract |
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