High mortality among mentally ill

Studies have shown that people experiencing serious mental illness are more likely to die as a result of untreated physical health problems than suicide or other mental health complications.

According to one American study, mental health patients in the US are dying 25 to 30 years earlier than other Americans, which is an increased gap from the 10 to 15 year difference that existed in the early 1990s.

Researchers in this study believe misperceptions about health care needs are part of the reason for this increasing gap in mortality.

Some of the most common causes of death among this population were complications from untreated or under-treated conditions such as metabolic disorders, cardiovascular disease and diabetes.

Increased incidence of obesity and smoking are also common – people with serious mental illness smoke 44 per cent of the cigarettes sold in the US.

Unfortunately, people with mental illness also tend to have a harder time accessing health care for a variety of reasons – not least of which is the stigma they continue to face even from medical professionals.

Although the above statistics are from a US-based study, a similar story exists within our own country. A 2007 study published in the Canadian Medical Association Journal found psychiatric status affects survival and access to medical procedures even within a universal health care system.

One major barrier to general medical treatment for the mentally ill is a growing unwillingness of physicians to deal with the complexities they feel might be involved. It is becoming increasingly common even here in Canada for a GP to request an interview and references when considering new patients.

Due to shortages and lack of time, some doctors are hesitant to accept patients if they come with time consuming or seemingly inconvenient problems such as chronic mental illness.

I personally have had patients request reference letters to assure GPs I will continue treating psychiatric issues and that the individual is reliable and willing to work with a doctor.

Advocates believe in order to prevent this increased mortality for those with mental illness, primary care and mental health professionals need to take equal responsibility in caring for these patients.

Not only should physical and mental health care be better integrated through closer communication between health care providers, but individuals themselves need to be educated on how to manage their illnesses – both mental and physical.

Studies have found improvements when nurse case managers have worked to coordinate both mental and physical care for patients - with care including ongoing patient education and communication.

As always, we need to move beyond stereotypes when dealing with mental illness. In spite of a psychiatric condition, other areas of health should not be neglected. People are never one-dimensional and should receive equal consideration regardless of mental health status.

More States of Mind articles

About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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