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Physical health in mental health: considerations for paramedics

02 January 2020
Volume 12 · Issue 1


Life expectancy for people with a mental illness diagnosis is 15–20 years less than those without, mainly because of poor physical health. Mental ill health affects a significant proportion of paramedics' patients, and practitioners could assess and promote their physical health even though contact time is limited. Factors affecting physical health include substandard and disjointed care, stigma and diagnostic overshadowing—where physical symptoms are dismissed as a feature of mental illness. Diagnostic overshadowing is not discussed in key paramedic literature, although patients with mental health problems are at risk of not having their physical needs being taken seriously. The paramedic's role in health promotion is receiving more attention. Making Every Contact Count (MECC)—a behaviour change model using brief interaction—could be adopted by paramedics to promote physical health, especially when linked to campaigns and local services. Health promotion is in its early days in paramedicine, and paramedics could learn from the experiences of other professions.

Research has consistently shown that the physical health of people with mental illness is poorer than that of the general population, and that this area is often neglected by health professionals (Collins et al, 2013). A variety of factors have been found to increase the risk of this group experiencing serious illness and premature death, many of which are out of the individual's control (Mutsatsa, 2015). Nash (2014) suggests that physical health is now considered an integral part of modern mental healthcare—embracing a holistic model incorporating mental, physical, emotional and social components—and this is reflected by the recent government drive to improve this area of mental healthcare (Department of Health and Social Care (DHSC), 2016).

One in four people in the UK will experience a mental health problem at some time (NHS England, 2018), so mental ill health affects a significant proportion of a paramedic's patients. Paramedics could use their contact with these patients as an opportunity to assess and promote their physical health’ (Public Health England, 2017).

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