The physical health problems of adults living in the community with an enduring mental health problem: a focus on prevalence, age, gender, social class and unitary authority utilising the 1998 Welsh Health Survey
The overarching aim of this thesis was to inform policy and practice influencing the quality of life for people with an enduring mental health problem living in Wales through an analysis and exploration of the physical health inequalities and inequities that may exist. The rationale for this thesis being that in order to promote better health for people with an enduring mental health problem, one has to initially define that problem, determine its extent and then subsequently inform policy and practice. Research questions included; 1. Does an enduring mental health problem make an individual more prone to a physical health problem within the population of Wales? 2. Within Wales, are other factors influential such as age, gender, where one lives, social class, lifestyle? Following an extensive literature review and secondary analysis of the Welsh Health Survey1998 (NAW, 1999), the following conclusions were drawn from the research. The Welsh Health Survey 1998 (NAW, 1999) is a robust dataset on which to conduct research into the physical health of people with an enduring mental health problem. Analysis of the survey highlighted that people with an enduring mental health problem in Wales experience significantly more physical health problems than the general population, revealing gross health inequalities and inequities. The findings have presented new data for Wales and are an original contribution to current knowledge. Twenty-three physical health problems were examined in total and new evidence emerged in relation to certain circulatory conditions, respiratory conditions, cancers, arthritis, back pain, varicose veins, young adults, gender differences and social class. The high rates of hypertension, angina, skin cancer and breast cancer in young adults with an enduring mental health problem are extremely concerning. Having an enduring mental health problem is not the single most significant factor in the development of physical health problems; a range of other variables are important, specifically age, gender, smoking and BMI. This has led the researcher to conclude that this finding has important implications for policy and practice. Current strategy, policy and models in practice may be failing to ensure that the holistic needs of people with mental health problems are met. The researcher proposes a conceptual framework to help understand the construct of physical ill-health in people with an enduring mental health problem, a prototype electronic Rapid Risk Assessment Filter for use in practice and a health promotion model. Developments in the role of the mental health nurse are also proposed. There are gaps in our current knowledge on this subject area, which require further exploration and research questions arising from the thesis are suggested.
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