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Community Ment Health J. 2018 Jul;54(5):507-513. doi: 10.1007/s10597-017-0198-4. Epub 2017 Nov 28.

A Doctor is in the House: Stakeholder Focus Groups About Expanded Scope of Practice of Community Psychiatrists.

Author information

1
The University of California, San Francisco, 1001 Potrero Avenue, 7M8, San Francisco, CA, 94110, USA. christina.mangurian@ucsf.edu.
2
The University of California, San Francisco, 1001 Potrero Avenue, 7M8, San Francisco, CA, 94110, USA.
3
New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 100, New York, NY, USA.
4
Florida Atlantic University, 777 Glades Road, BC-71 Rm 241, Boca Raton, FL, USA.

Abstract

We sought to understand stakeholder perspectives on barriers to metabolic screening for people with severe mental illness. We additionally assessed the feasibility of expanding psychiatrists' scope of practice to include treatment of cardiometabolic abnormalities. We conducted four focus groups among patients with severe mental illness, community psychiatrists, primary care providers, and public health administrators. Focus group transcripts were thematically analyzed. Three domains emerged: challenges with patient navigation of the complex health care system, problem list prioritization difficulties, and concern that treatment of cardiometabolic abnormalities were beyond the scope of practice of psychiatrists. Stakeholders agreed that navigating the health care system was challenging for this population and led to undertreatment of cardiometabolic risk factors. Expansion of psychiatrists' scope of practice within community mental health appears acceptable to patients and may be a mechanism to improve cardiometabolic care among people with severe mental illness.

KEYWORDS:

Barriers to care; Metabolic screening; Severe mental illness; Stakeholder focus group

PMID:
29185153
PMCID:
PMC6218641
[Available on 2019-07-01]
DOI:
10.1007/s10597-017-0198-4

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