Sending mentally ill to an early grave costs us all dearly
People with serious mental illnesses are dying much younger than other Australians because they have high rates of common ailments like heart disease and diabetes that are not being adequately treated.
A report has found that almost 80 per cent of people with schizophrenia, bipolar disorder, severe anxiety, depression and other serious mental illnesses – estimated to be around 380,000 - are losing between 10 and 36 years of life because of health problems that are successfully managed in the broader community.
The study, commissioned by the Royal Australian and New Zealand College of Psychiatrists, says this is not only distressing for individuals and families, but is costing the country at least $15 billion a year in lost productivity and potentially avoidable visits to GPs and hospitals.
College President Professor Malcolm Hopwood said it had long been known that people with serious mental illnesses lived shorter lives, but “until recently there was no clear reason why this was so. Now we know the answer”.
The report, prepared by the Victoria Institute of Strategic Economic Studies, said that for people with mental disorders, comorbidities like heart disease, asthma and diabetes were “the rule, rather than the exception”.
It showed the majority of such people lost their lives to a combination of chronic physical conditions such as cardiovascular and respiratory diseases, cancer and diabetes.
“These deaths are mostly caused by illnesses commonly treated successfully in the broader community,” the report said. “In many cases, it appears that the gains made in the treatment of these conditions in recent decades have not occurred for people with mental illness.”
While the life expectancy of the broader population is increasing, the study cited research indicating that among those with serious mental illness it was actually declining.
Professor Hopwood said the prevalence of poor physical health and inadequate treatment were complex, and improving care of the seriously mentally ill would not be easy.
Among the issues are the need for greater recognition that patients with a serious mental illness will likely also have comorbid physical ailments, as well as factors like cost and availability that might discourage such people from seeking treatment.
“We are facing a mixture of ‘treatment vexation’, low socioeconomic status, high risk behaviours, difficult-to-access treatment, fragmented services, affordability challenges, stigma, discrimination, and poor clinician confidence – all exacerbated by a lack of funding,” Professor Hopwood said.
Among suggested improvements is an increase in consultation times reimbursed by Medicare and improved collaboration between health professionals, which could help realise significant savings.
The Australian Health Policy Collaboration, which participated in commissioning the research, has estimated that providing the seriously mentally ill with best practice health care could save around $5 billion a year.
Published: 19 Apr 2016