During my initial assessment of patients, I discuss individual recovery goals and how medication and other treatment can help the patient achieve his or her goals; this discussion continues throughout treatment. I ask if the patient would like a family session, and I include family psychoeducation as needed.
A variety of educational pamphlets and handouts on topics such as schizophrenia, recovery, and nutrition are readily available in my office, in the waiting rooms, and on bulletin boards. A brief physical health history is included in the initial assessment. I provide education about the higher risk of medical morbidity and mortality, and the patient and I collaborate on a prevention plan. If nicotine dependence and obesity are present, they are discussed and documented along with other physical health problems.
Asking patients to rate their interest and confidence in taking medication, quitting smoking, and losing weight on a scale of 1 to 10 can be enlightening. Use of pill-reminder boxes and appointment calendars is frequently recommended. These strategies can be used whether the provider is in private practice or is working in a clinic setting.
Recovery-oriented and physical health goals are included in the individual’s service plan. My organization maintains a Medical Providers Database with practitioners interested in treating patients with mental illness along with the insurance plans they accept, and referrals are made when needed.
Medication fact sheets are available to help guide medication counseling discussions. If the patient is receiving an atypical antipsychotic, information is provided about the weight gain potentials of the various agents, the possible metabolic effects, and the need to monitor for adverse effects. Baseline and ongoing weights are tracked. Brief nutritional and physical activity advice are offered, along with a variety of educational handouts that include a self-monitoring log for weight and other health measures. Handouts on topics such as stress management are also available. In addition, there are several wellness stations where patients can self-monitor their weight and other health measures and where there is easy access to a variety of patient educational materials.
In some communities, peer services may be available; practitioners can check with organizations such as the Division of Mental Health Services for a listing of peer-run services.
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