Psychiatrists call for action over premature deaths of mentally ill
Experts say it is time to close the gap between treatment of physical and mental illnesses
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Wednesday 19 June 2013
An international group of psychiatrists today launches a drive to end the global scandal of premature deaths among people suffering from severe mental illness.
UK figures show their death rate is nearly four times higher than that among the general population. On average, young people diagnosed with schizophrenia and other psychotic illnesses die 15 to 20 years earlier than their peers as a result of a combination of the effects of anti-psychotic drugs and a poor lifestyle.
But psychiatrists say the epidemic of early death could be curbed if mentally ill patients were given the same treatment for their physical illnesses as enjoyed by the rest of the population. The Health and Social Care Information Centre released figures yesterday showing people with mental problems use hospitals twice as much as those with physical problems.
Last February the centre published figures showing the death rate was 3.6 times higher than that among the general population in 2010-11. In a statement published today, psychiatrists from 11 countries including the UK and Australia say young people with severe mental illness suffer “stigma, discrimination and prejudice” that prevent them from leading healthy, active lives. They are up to three times more likely to develop heart disease and diabetes and up to four times more likely to smoke, but their problems often go undiagnosed and they are not offered treatment or help.
Anti-psychotic drugs prescribed to people with mental illness often cause rapid weight gain, with some patients becoming clinically obese. Many patients also self-medicate with alcohol and drugs such as cannabis.
Targets set by the international group include ensuring at least three-quarters of patients gain no more than 7 per cent in weight over the first two years and blood tests for diabetes and heart disease remain normal.
Dr David Shiers, co-author of the “Healthy Active Lives” statement, said: “The evidence is now clear – weight gain, cardiovascular risk and metabolic disturbance commonly appear early in the course of emerging psychosis and are potentially modifiable. As clinicians, if we dismiss these disturbances as being of secondary to controlling their psychiatric symptoms, we may be inadvertently condoning a first step on a path towards physical health inequalities for these young people. This vulnerable group needs a far more holistic and preventive approach.”
Professor Sue Bailey, president of the Royal College of Psychiatrists, said: “A person’s physical and mental health influence one another: deficiency in the care of one can lead to serious problems with the other.”
The statement says that two years after the onset of psychosis, fewer than 30 per cent of patients should still be smoking and more than half should be taking recommended levels of exercise. The aim is to reduce the inequalities suffered by people with mental illness and close the chasm that exists between the quality of their treatment and that of people with physical illnesses.
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