People with mental illnesses face a gap in life expectancy of about 20 years, a new Australian-led report suggests, and experts say early intervention in physical health is a key to closing that gap.
“The disparities in physical health outcomes for people with mental illness are currently regarded as a human rights scandal,” said Dr Joseph Firth, chairman of the Lancet Psychiatry Commission*.
“The actual extent of these inequalities is growing with time, it’s actually becoming worse, the difference in life expectancy between people with mental illness and the general population.”
Early intervention in physical health is one of the main recommendations that came out of 12 months of research, Dr Firth said.
“It’s actually much easier and much more feasible when we’re talking about preventing these conditions from arising rather than trying to reverse the condition after it’s arisen.”
The commission’s lifestyle section lead, Dr Simon Rosenbaum, said there was an intricate link between physical and mental health and while physical health is not a cure for mental illness, it does help reduce symptoms.
“There’s strong evidence now exercise can reduce symptoms in a range of mental disorders, from PTSD to depression, anxiety, schizophrenia,” he said.
‘Benefited me enormously’
Andrew Skelton, 26, was on antidepressants and seeing a counsellor every week when he joined a Sydney program that tackles both mental and physical health.
The Keeping the Body in Mind (KBIM) program, run by the South Eastern Sydney Local Health District, is designed to help young people stay fit and healthy as they start treatment and medication for psychosis.
Mr Skelton, who was discharged from the program in January, said it had been “really fantastic” in helping him take up running and set fitness goals.
“I’ve found that exercise has been really effective for helping me when I’m feeling acutely anxious and also just in terms of just keeping my mood higher, at a more healthy level,” he said.
“It’s something that I’m enjoying a lot and has benefited me enormously.”
Clinical director of the program, Dr Jackie Curtis, said they employ an exercise physiologist, a dietitian, a specialist mental health nurse and a peer worker, to help motivate young people as they are beginning treatment for psychosis.
“We evaluated the 12-week lifestyle intervention, and we found that we were able to prevent antipsychotic drug-induced weight gain,” she said.
Cardiovascular disease, obesity and diabetes contribute to life expectancy gap
Cardiovascular disease, obesity and diabetes had some of the largest effects on the mortality rate of people with mental illness, according to the report published in Lancet Psychiatry on Wednesday.
Dr Firth, who is a senior research fellow at NICM Health Research Institute, Western Sydney University, said all common and severe mental disorders were associated with a double or a three-fold risk of these diseases.
“[These diseases] impact on quality of life and recovery, while contributing towards a 20-year gap in life expectancy currently experienced by this undeserved population.”
Dr Rosenbaum, a Scientia fellow and NHMRC research fellow at UNSW, said people with mental illness face greater hurdles when it comes to improving physical health.
“Often the physical health issues are put aside or ignored in favour of addressing the mental health as a priority,” he said.
Professor Ian Hickie, from the University of Sydney’s Brain and Mind Centre, said it was good the report emphasised the importance of early intervention in health for people with mental illness, but real action needed to be taken by government.
“The danger like many other comprehensive reports is if it doesn’t result in any action,” he said.
“I think the good news is worldwide you hope that these things do reach a tipping point, but that requires local action.”
In order to implement the changes in the report, Professor Hickie said Australia would require a “fundamental reshaping” of the Medicare system.
However, Dr Curtis, who is also a Lancet Psychiatry Commission author, said in the roughly 15 years she has been working to combine physical and mental health care she has seen a shift in Australia.
“There’s a long way to go because we’ve got to close the premature mortality gap, but at least I see a change, and the commission is just highlighting the evidence,” she said.
“No one could refute this as an issue now.”
Source Credit: https://www.smh.com.au/healthcare/mental-illness-means-shorter-life-expectancy-but-physical-health-is-key-experts-say-20190716-p527te.html?fbclid=IwAR2pOvSEwj5vxPj5zZnXgSAy3BPLCXzR7JrM2jfVsTO_9-HTvW-ZZRFqUDg