Oral health experiences and needs among young adults after a first-episode psychosis : a phenomenological study

Abstract

What is known on the subject?: Substance abuse, poor lifestyle and side effects of medication often occur and cause oral health problems in patients diagnosed with severe mental illness (SMI). Oral health in SMI is related to quality of life, self-esteem, and daily functioning. Despite its importance, oral health in mental health care is still a postponed healthcare pathway. Treatment guidelines on patients after a first episode psychosis (FEP) indicate that interventions are recommended, but clinical advice is lacking. However, no research on the experiences of young adults’ oral health after FEP has been conducted. What does this paper add to existing knowledge?: This study is the first study to gain insight into most important experiences in patients after FEP regarding oral health. After FEP, participants experience many risk factors, for example substance use, poor diet and financial problems, and participants are not able to adequately attend to their oral health. There is a lack of awareness among participants after FEP about oral health and participants do have high burden. After FEP, participants need support and help from their environment to maintain their oral health. What are the implications for practice?: In FEP, oral health needs more attention to avoid the negative consequences in a later phase of the illness. To fill the gap between patients’ needs regarding oral health care and the attention of mental healthcare professionals, the awareness of patients and mental health professionals concerning oral health should be heightened, and clinical interventions to support these needs should be developed. Abstract: Introduction Oral health affects quality of life, self-esteem, physical health and daily functioning. Treatment guidelines on patients after first episode psychosis (FEP) recommend interventions, but clinical interventions are lacking. No research on the experiences of young adults’ oral health after FEP has been conducted. Aims This study aimed to explore the lived experiences and needs of patients after FEP with regard to their oral health. Design and Methods Single-centre phenomenological study using open interviews (N = 30). Data were analysed using the Colaizzi method. Results Patients reported oral health problems since their FEP. The problems that patients encountered were dental care in general (e.g., a lack of awareness), risk factors (e.g., substance use, poor diet and financial problems), overall experiences with dentists/dental hygienists and the gap between needs and interventions. Discussion There is a lack of awareness among patients after FEP about oral health while patients are not able to adequately attend to their oral health and patients have high burden on this topic. Implications for mental health nursing To bridge the gap between patients’ needs regarding oral health, the awareness of patients and mental health professionals should be heightened, and patients should be better supported by mental health professionals.