Sunday, June 04, 2006

Physical health and the mentally ill

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A study from the UK, presented to the American Psychiatric Association, has revealed that physical health problems often go undetected in the mental health population.

It is reported that people with severe mental health problems tend to have higher rates of heart disease and diabetes and die between 10 and 15 years earlier than those not affected by such conditions. However, less than one third of 966 individuals with serious mental illness reviewed as part of the study had received health checks to assess their physical state. Moreover, the study revealed high smoking, blood pressure and obesity rates among participants.

Unfortunately, while this highlights the importance of looking at the wider needs of the mentally ill, it seems that little has changed. Similar findings were reported by UK mental health charity Rethink, formerly the National Schizophrenia Fellowship (NSF), in 2002, with the NSF requesting annual physical checkups for all individuals experiencing mental illness.

Paul Corry, of UK mental health charity Rethink says that "Physical decline can be as serious a risk as mental illness in those with serious mental illness. It is critical that annual physical health checks are built into ongoing management plans so that people with severe mental illness can optimise their quality of life and achieve a sense of physical and mental well-being."

Let's hope someone is prepared to act this time around.

Resources:

Fear over health of mentally ill
Health check demand for mentally ill
Physical health of people with severe mental illness

11 comments:

jumpinginpuddles said...

Although we dont classify ourselves as seriously mentally ill ;) actually we dont think we are mentally ill at all. we tend to agree with this blog, our health recently because of both internal and external problems has declined.
A recent bout of shingles and a cold we now cant rid of is an example of this. Although stress can play a major part of course i do believe also that physical and mental do go together, on many more occassions than people have up till recently recognised.

Tiesha said...

This is interesting and part of my interests if I can ever get myself done with school! I'm always bothered by this and I used to see it when I worked in the ER. Either the mental illness or the physical illness was neglected, never integrated. I think some good psych care should be incorporated into everyone's primary care. Also, it's this sort of thing that got me started on SAFE-T-KID. I was appalled to find out that pediatric psych nurses could deal with all sorts of behavior, but they had absolutely no idea how to assess respiratory function during restraints. Great post! I always learn so much!

healthpsych said...

Hi JIP,
Shingles is misery. I hope you're soon feeling better. Physical and mental health is very much intertwined as you say.

Hi Tiesha,
Yes, it seems it must be one or the other, never the two together. I was horrified to read in your blog about the lack of assessment of respiratory function. Even as a layperson, this seemed rather a basic function to me

Dr. Deborah Serani said...

So true. This is a great post, and one that I hope many will read.

Kim said...

Definitely a problem.

I'm wondering if the an inability of those with severe mental health problems to cope with medication and exercise regimes may contribute. They have enough trouble sticking to their psych medications but to expect them to not only understand, but comply with dietary, exercise and other medications....

So do you first tackle the mental issues so that the patient is more enabled to take care of their physical needs or can working with the physical problems help them cope with the mental illness?

My guess is that it would depend on the individual.

healthpsych said...

Hi Deb,
Thanks for the comment.

Hi Kim,

You raise an interesting point and, as you say, the answer probably lies in each individual's circumstances. There's certainly no standard fix to the resolution of health problems in the mentally ill population.

I think the point of the study is that things aren't even getting to this point though. An annual check to detect/monitor potential physical problems needs to be routinely incorporated into mental health care.

Thanks for commenting.

Sarebear said...

Yeah, on the patient side of things, as some of the commenters say, being mentally ill makes it pretty much impossible for me to be consistent at anything. I do take hope though, in the fact that, since the only thing I'm consistent at is being inconsistent, at least that's evidence I'm consistent at SOMETHING!

Untwist your brains from that twister now.

On the issues of the health care providers, both mental and physical (and, aren't there times people go to psychologist to help with their migraines, etc? so it's not so clearcut) I think, at least in my case, I worry so much about having so many health problems, that perhaps my worries have been discounted and brushed off . . . I know my GP did this, and I like him and he's a GOOD GP. Very busy, but a good, personable, doc.

And then, there are so many things that I think are just because I worry so much, that I DON'T mention, that, as therapy is going on, now, I'm discovering inside that maybe there are alot of assumptions about both my thoughts, and about my physical health, that I need to look at in a new light, and mention.

And to trust my gut, no matter that I do tend to worry overmuch (and, thus, tend to overfilter much because I KNOW I worry too much), and push for whatever doc or type of doc to help me figure out whatever it is I'm concerned about. If I'm THAT worried about it, and the insurance that we will be having soon doesn't want to cover the test, I'll pay it (well, obviously not an MRI type, but a FEW x-rays, and, like last August, a thyroid and also a diabetes test, as I was worried about the latter, and wanted the thyroid number because I wanted to eliminate that as a factor in my moodiness, etc.

Sorry to go on so long! But I said, hey, I'd really like to know on this, and I said why, and that I'd be paying OOP for them, since we had no Insurance, and he was happy to do it.

I just think that being able to properly mentally filter and prioritize, and even REALIZE, that some physical things are something that needs mentioning, can be a problem for the mentally ill.

I also think that, even when we do mention stuff, quite often improperly prioritized, emphasizing things that maybe aren't as important as others, and then again, might be, that the docs don't have as much . . . . material? from us, as in, they can't really "read" how real, pressing, or other factors of the problems that are going on.

I'm stumbling over what I'm trying to say, but I think I've said it, sort of. Lol!

Sara

healthpsych said...

Hi Sarebear,

Thank you for your insightful comment.

Always good to check out things like thyroid as possible contributors to poor mood - particularly as quite often a thyroid problem can go undetected in the early stages.

As you can say, it can be difficult for someone with a mental illness to remember to address these issues, hence the importance of a routine health screening for such individuals.

And then there's the overlap between physical symptoms and some of the symptoms of mental disorders. Think about the overlap between hypoglycaemia and anxiety symptoms or the fatigue commonly seen in physical conditions and in depression. It can mean that sometimes people can be falsely diagnosed with depression or anxiety OR that such a diagnosis is missed because such symptoms are believed to be part of a medical condition.

Daniel Haszard said...

Well said,i applaud your blog, mental health consumers are the least capable of self advocacy,my doctors made me take zyprexa for 4 years which was ineffective for my symptoms.I now have a victims support page against Eli Lilly for it's Zyprexa product causing my diabetes.--Daniel Haszard www.zyprexa-victims.com

Health said...

Wow! So, physical health has a connection with those who are mentally ill. It's good that sites like this do exist to make people more aware about the state of their health and its solution.

Clenbuterol said...

I am absolutely sure that these two spheres are interrelated very tightly.