Medical Self Advocacy

Many people living with mental illness do not have access to quality medical care that meets all of their health care needs. Often, when someone tells a health care provider that he or she is taking antipsychotic medications or has a serious mental illness, a person will receive a lower quality of care or less attention. NAMI's survey of individuals living with schizophrenia reveals that sometimes simply sharing a diagnosis with a health care provider results in poor care.

True, this should serve as a wake-up call for health care providers, but it is crucial that people who live with mental illness advocate for their own health care and work to change the very culture that promotes these unfair experiences.

We should see health care providers as allies. You can take steps to make sure that you are communicating your concerns regarding your mental illness, but you should also think what else you can do to prevent or address other medical conditions, too.

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) is taking strides to address the priority of integrated mental health and primary health care. Learn more about SAMHSA's efforts to support this effort.

Antipsychotic Medication Side Effects

Research shows that doctors are not yet doing the best job of monitoring the risk of antipsychotic medications.

You can take action to make sure that this important health concern is not overlooked. Saying something like, "I believe that my meds carry heart risks. Can you help follow this with me?," will probably be enough. Once prompted, health care providers know the right blood tests to order. They know to check weight, waist circumference and blood pressure as well as ask about a family history of heart disease. They may need to be reminded on subsequent visits, but persistence is important. It often takes years for the latest scientific findings to become part of daily practice.

Access to good information is important to good decision making. All practitioners who prescribe medications should routinely share possible side effects, particularly those of second-generation atypical antipsychotic medications (SGAs). These include:

• increased appetite;
• decreased sense of fullness;
• increased risk of weight gain; and
• diabetes.

For more information on this topic and for a list of how the different SGAs stack up in terms of risks of weight gain and obesity, review the American Diabetes Association and American Psychiatric Association's Guidelines on atypical antipsychotic medications. Learn more about mental illness and metabolic syndrome and diabetes.

You should feel empowered to talk about this topic with your health care provider and let him or her know that you would appreciate being kept well-informed about side effects and other issues relating to specific medications and treatment plans. This is the kind of care you deserve.

The side effect of weight gain is a big concern. Weight loss is a challenge for most people. The NAMI Hearts and Minds sections on exercise and healthy eating offer more information and ideas for dealing with this condition. Be sure to talk with a health care provider before significantly increasing your activity level or beginning a weight loss program.