“Mental health overwhelms everything else”: Facilitators and barriers to health self-management by people living with mental illness

The higher rate of morbidity and mortality from all the major health conditions for those with a mental illness is well known (Lawrence, Holman &Jablensky 2001). Encouraging mental health consumers to self-manage their physical health may help overcome this inequity (Wagner, 2001). The purpose of this study was to investigate facilitators and barriers to physical health self-management by people with a mental illness living in the community. Twenty -seven participants who had a diagnosed mental illness and a co-morbid chronic physical health condition were included in one of three focus groups for this qualitative study. Data were analysed thematically. Participants were aware of the need to attend to their physical health but we identified a number of interrelated factors that occurred at the personal, social and structural levels that hampered or supported their ability to do so. At the personal level, self-management was hampered by the impact of mental illness, side effects of medication, poor health literacy and prioritising of mental over physical health. Social level barriers and facilitators reflect the influence of participants' social network - personal and professional. Low income, lack of coordinated health services and 'mental health friendly' sites and the policies and procedures of many mental health agencies were perceived as structural barriers to self-management. Learning Objectives: 1.The audience will learn about the concerns people living with mental illness have about their physical health. 2.The audience will gain an appreciation of the facilitators and substantial barriers to good health care experienced by people who live with mental illness.