Department of Veterans Affairs, Northeast Program Evaluation Center.
Institute for Behavioral Health, Heller School of Social Policy and Management, Brandeis University.
Psychiatr Rehabil J. 2022 Dec;45(4):343-351. doi: 10.1037/prj0000522. Epub 2022 Jul 7.
Individuals with serious mental illness (SMI) experience a 10-25-year reduced life expectancy when compared to the general population that is due, in part, to poor health behaviors. Yet, in spite of the development of health promotion and self-management interventions designed for people with SMI to promote health behavior change, the mortality gap has increased, suggesting that relevant factors are not being addressed. The objective of the present study was to explore potential contributors to early mortality among individuals with SMI by drawing from the lived experience of certified peer support specialists and service users (SUs).
Face-to-face semistructured interviews were conducted with a convenience sample of SU participants ( = 17) and certified peer specialists ( = 15). Qualitative data were analyzed using a grounded-theory approach.
We identified a final set of 27 codes relating to five overarching themes that relate to both risk factors and protective factors for early death: social connectedness (24.1% of coded items), treatment (21.3%), coping (21.3%), physical health and wellness (18.5%), and resilience and mental health (14.8%).
Findings add to the literature supporting the powerful role of social processes in shaping health in people with SMI beyond social determinants of health (SDOH; e.g., income, employment) and health behavior change. Interventions that reduce loneliness and isolation in combination with addressing more conventional SDOH may have the most potential to reduce early mortality in people with SMI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
与普通人群相比，患有严重精神疾病（SMI）的个体预期寿命缩短了 10-25 年，部分原因是健康行为不佳。然而，尽管已经开发了针对 SMI 患者的健康促进和自我管理干预措施来促进健康行为的改变，但死亡率差距仍在扩大，这表明相关因素并未得到解决。本研究的目的是通过借鉴经过认证的同伴支持专家和服务使用者（SU）的生活经验，探讨 SMI 个体早期死亡的潜在原因。
采用方便抽样法对 SU 参与者（n=17）和经过认证的同伴专家（n=15）进行了面对面半结构化访谈。使用扎根理论方法对定性数据进行分析。
我们确定了 27 个最终代码，这些代码与五个总体主题相关，涉及到早期死亡的风险因素和保护因素：社会联系（24.1%的编码项目）、治疗（21.3%）、应对（21.3%）、身心健康（18.5%）和韧性和心理健康（14.8%）。
研究结果增加了文献支持，即社会过程在塑造 SMI 患者的健康方面发挥着强大的作用，超出了健康的社会决定因素（如收入、就业）和健康行为改变。减少孤独和孤立的干预措施结合解决更传统的社会决定因素，可能对减少 SMI 患者的早期死亡最有潜力。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
