Page 158 - Demo

Chapter 7156Compared with people with no ID, people with MID are likely to experience MH problems and encounter GPs or MH services at a much younger age (Chapters 3 and 4). Bob too developed MH problems at an early age (17 years), with considerable impact on the rest of his life.GPs and mental health nurse practitioners (MHNPs) characterize people with both MID and MH as patients with multiple problems, both medical and non-medical, present at the same time. According to GPs and MHNPS, these multi-problems often need to be addressed simultaneously and contribute to the difficulties that they experience in providing and organizing the appropriate care and support for this patient group (Chapter 6). Bob also experienced problems in several life domains, often in the same period: depression, loneliness, financial debts, no stable work, substance use. This accumulation of problems worsened Bob’s situation over time. Sustainable formal and informal patients’ networks can play an important supportive role in the MH trajectory for patients with MID, but also for GPs and MHNPs (Chapters 2, 5, and 6). In Bob’s case, he was able to thrive and develop in the presence of a supportive network of formal caregivers from the age of 25, after a long period of absence of support from family and friends when he was living on his own. Signs of undertreatment of people with MID in advanced MH services, particularly when the MID is not registered as such, were revealed by our population-based MH service database study. This is reflected in shorter trajectories and fewer treatment and diagnostic activities compared with patients with no ID, in these services. Disturbingly, patients with MID need more crisis interventions and MH hospital admissions (Chapter 4). In addition, in both primary care and specialized MH care, there is a high prevalence of unspecified MH diagnoses that may indicate that professionals struggle with establishing the appropriate MH diagnosis and associated suitable treatment for patients with MID (Chapters 2 and 3). Bob clearly did not benefit from the treatment in MH services, as reflected in his multiple re-admissions, which may have resulted in his being seen as an unmotivated patient who did not adhere to therapy, according to care professionals.Katrien Pouls sHL.indd 156 24-06-2024 16:26