Perspectives from resource poor settings

edge about specific medication effects and greater attention to the possible impact of psychotropic medications on the physical health of people with SMI can aid psychiatrists in selecting appropriate treatment. The same is true for primary care providers. Some primary care professionals hold negative attitudes toward this vulnerable group, or wrongly attribute physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions. It seems that there still is a lack of awareness among these providers that people with SMI face a greater risk of developing physical illnesses, such as heart disease, obesity and diabetes. Primary care providers may also not be knowledgeable about the health risks associated with psychotropic medications and the resulting health monitoring that is indicated for persons with SMI. They therefore should specifically be trained to identify and treat physical health problems in people with SMI. It is clear that deficiencies in the care of those with SMI, due to cultural and educational factors and unclear roles and responsibilities of their providers, continue to leave many service users with SMI vulnerable to serious physical health issues, which may limit their recovery. We can change these aspects through educational innovations. Only then we can leave the road of Cheshire cat and will multilevel interventions or strategies, as those proposed by Liu et al, result in improved outcomes for people with SMI.