Revolutionizing Mental Health Care: Lessons from a Patient’s Death
TL/DR –
The author shares a personal story about a patient named “John” with severe mental illness (SMI) who died under a system that did not take his physical medical history seriously enough. The author believes that there is a significant need to improve comorbidity in individuals with SMI through better preventative screening measures, monitoring metabolic functioning, managing metabolic abnormalities, and implementing integrated care measures. Changes need to be made at the system and policy levels to close the gap in care for patients with SMI and improve overall physical and mental health regarding longevity and quality of life.
Mental Health Care: A Transformative Approach Post Patient’s Death
Working as a psychiatric registered nurse, I witnessed the challenges of individuals with Severe Mental Illness (SMI), who often suffer from other medical conditions, reducing their life expectancy by 10-20 years compared to the general population. The impact of this reality became more apparent through my experience with a patient I’ll refer to as “John”.
John, a middle-aged individual, was newly admitted to our psychiatric facility due to psychosis symptoms. He had a significant medical history, including several heart surgeries and aortic aneurysms. Later, he complained of throat and chest tightness. Based on an EKG test, we suspected a possible anteroseptal myocardial infarction and sent John to a local medical hospital for further evaluation.
Contrary to expectations, John was cleared with a pneumonia diagnosis and returned to our psychiatric facility, only to be found unresponsive the next morning. His death highlighted the urgent need for providers to fully appreciate the complexity of a patient’s condition and fight to ensure their survival.
John’s unfortunate death has significantly influenced my outlook on healthcare, igniting my passion to advocate for this vulnerable population. Despite moving out of the inpatient setting, I aim to help improve comorbidity in individuals with SMI, particularly in community mental health.
To do this, I propose better preventative screening measures, particularly monitoring metabolic functioning, and managing metabolic abnormalities with the help of primary care providers. An integrated care approach will help in early identification of metabolic issues, which can significantly enhance the physical and mental health outcomes of these individuals.
Substantial changes are necessary at the system and policy levels to bridge the gap in the early mortality of individuals with SMI. However, the first steps can be taken in our own clinical practice environments. On a patient level, I strive to provide evidence-based treatment for long-term healing and recovery, and on a systems level, I work towards reducing the stigma of mental illness.
My vision for mental health care is achieving parity between mental and physical health. I strive for this ideal daily, remembering John’s story and aiming to prevent such outcomes in the future.
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