Sunday, 16 January 2005 - 8:00 AM

This presentation is part of: Beyond Mental Health Treatment: Research on Psychosocial Rehabilitation Services

Self-Assessed Health Among Individuals with Mental Illnesses

1. Self-Assessed Health Among Individuals with Mental Illnesses

Purpose: Poor self-assessed health is universally associated with increased mortality and morbidity. Unfortunately, individuals with severe mental illnesses (SMI) report poorer self-assessed health. They also have higher mortality and morbidity than the general population. This study describes the self-assessed health of individuals with SMI, compares them to the general US population, and examines how failure to seek medical care, physical and psychological problems, and other risk factors are associated with self-assessed health among persons with severe mental illnesses.

Methods: The data come from a cross-sectional study of the health and mental health of individuals with psychiatric disabilities living in the Greater San Francisco Bay Area: 673 new clients with SMI seeking mental health services. Comparisons to the US population use 1999 National Health Interview Survey (NHIS) statistics. Self-assessed health status was a response to a single question, “At the present time, would you say your health is 1) poor; 2) fair; 3) good; 4) excellent.” Using OLS regression, seven factors were considered as self-assessed health determinants: psychological and physical health problems, failure to seek needed health care, physical risk indicators, substance abuse risk indicators, care enablers and detractors, environmental health risks, and self and context confounders.

Results: The group with SMI were eight times more likely to assess their health as “poor” than the US comparison group and three times more likely to do so than people in poverty in the US. Psychological and physical health problems and failure to seek medical care were the only significant determinants of SMI self-assessed health.

Implications: SMI self-assessed health is primarily a function of ongoing serious medical and psychological problems as well as a failure to seek needed medical care. Decreasing barriers to needed medical care and providing education on the importance of health risks are new and important roles for psychosocial rehabilitation programs.

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