Use of primary health care services among patients with severe mental illness

Maria Moreira, Alexandra Pimentel, Francisca Salgado, Gustavo Santos

Keywords: mental health, severe mental illness, primary health care

Background:

Severe mental illness (SMI) by definition affects the individual's functionality in a prolonged or continuous manner, being associated with high mortality due to organic disease.

Research questions:

This study aims to assess the use of Primary Health Care (PHC) services by patients with SMI, through face-to-face consultations (FC) and non-face-to-face contacts (NFC).

Method:

Cross-sectional analytical study. Population: patients hospitalized in the Community Mental Health Service of Porto, 2019-2021. Exclusions: patients without a General Practitioner (GP); blocked access to the Electronic Health Record; deceased. Data collection from electronic clinical records. Analysis performed in SPSS®, considering an alpha of 5%.

Results:

From the final study population of 181 patients, the majority were hospitalized due to psychosis (50.3%). Some had Diabetes Mellitus (DM 13.3%), Hypertension (HTN 21%), and Obesity/Overweight (O 45.9%). It was found that 53% of the population had one or more NFC, 36% had no FC, 16% had one FC, and 48% had two or more FC. Most of the eligible population did not have updated cancer screenings (55.6%).

Conclusions:

Despite an important percentage of the population having NFC and at least one FC, the majority of the eligible population did not have updated populational screenings. A smaller number of NFC was associated with psychosis. Drug dependence was associated with a smaller number of FC, as this population has known limitations in accessing PHC. On the other hand, a higher number of FC was associated with Depressive/Anxiety Disorder. Regarding the updating of cancer screenings, a positive association was observed with Adjustment Disorder. Patients diagnosed with DM or HTN had a higher number of NFC, FC, and updated cancer screenings, clearly related to the organized follow-up established by their respective integrated care processes.
It is crucial to promote health professionals' literacy regarding the needs of this specific population.

Points for discussion:

Barriers to the use of primary health care services among patients with mental illness

Mental illness stigma among health care professionals

Study limitations

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