In an unusual public mea culpa, psychiatrists have accepted that a “tendency to protect our professional turf without a good understanding of the consequences” is partly to blame for the “appalling” lower life expectancy of people with mental illness.
The lives of people with serious mental illness are shorter by up to 30 per cent – 10 to 36 years – than those of the general population. And in Australia, the gap is widening.
But just under 80 per cent of the excess deaths of people with mental illness are caused by largely preventable physical illnesses that are successfully treated in the general population, such as heart and respiratory diseases and some cancers.
“Working in medical silos” had led to the “truly shocking” situation, the incoming president of the Royal Australian and New Zealand College of Psychiatrists Kym Jenkins told the Consumer Health Forum earlier this month.
A RANZCP report this year admits that “some psychiatrists and others working in the mental health field do not recognise the treatment of physical symptoms as a key part of their role”.
Yet the anti-psychotic medicines they (and other doctors) prescribe can cause side effects “that often lead to a range of chronic, life-shortening illnesses such as diabetes and cardiovascular disease”.
RANZCP president Malcolm Hopwood said mental health problems also make it hard for people to access physical health care.
Despite being sicker than many others in the community, people with serious mental illness actually use all health services much less, the RANZCP report says.
When they do seek treatment, “unhelpful and discriminatory attitudes” and “a culture of hopelessness and low expectations” that pervades the health system in relation to mental illness “directly contributes to the shorter life expectancy”, the report says.
Dr Jenkins, on behalf of the RANZCP, called on fellow psychiatrists to “step up their efforts” to build “meaningful connections with their all-important colleagues in primary health care” (GPs and community clinics) and share responsibility for patients’ overall health.
Professor Hopwood said the national mental health reform goals of integrating mental health services with primary health care, in which regional Primary Health Care Networks are to play a key role matching service provision to local needs, is an important next step on the path to reform.
“Whatever reforms we have done to this point, the fact that people are still dying that much younger is simply not acceptable,” Professor Hopwood said.
This article first appeared on Sydney Morning Herald on 19 December 2015.