Why Mentally Ill are having their Physical Health neglected by Doctors

24 Jun

Patients with severe mental illnesses tragically die approximately 20 years earlier then the average citizen.
There are numerous causes for this as detailed below.

Reblogged from http://mentalhealthconnect.com.au/wordpress/summer-forum-2013-john-allan-putting-practice-in-place-for-healthy-living-for-people-with-mental-illness/

Summer Forum 2013 – John Allan – Putting practice in place for healthy living for people with mental illness
Feb 25th, 2013 by HamishH
John Allan is the Chief Psychiatrist of NSW and presented on the topic of implementing healthy living practices with people with mental illness.

John argued for the importance of setting clear and simple targets which are achievable and relevant to people with mental health problems.

John looked back the history of psychiatry and asked how far have we actually come? For example, life expectancy for people with serious mental illness was about the same as the life expectancy of the general population in 1910, now it is over 20 years less than the life expectancy for the general Australian population.

John reflected on the policy/practice divide… so what are the barriers for mental health consumers accessing physical health care?

Practicalities:

Inaccessibility of services and distance to services
Mistrust
Homelessness
Social isolation
Interpersonal barriers

Mental health care providers often do not ask about physical health care
Lack of information
An attitude from  service providers that it’s “not my problem”
Participants in studies in this area had a good awareness of the range of options in the community but clinicians often didn’t
Other barriers

Poor coordination between physical and mental health care providers
Diagnostic overshadowing: patients are “seen to be faking” – people feel they have to hide mental illness to get service, or act in ways that do get them service but that have them labelled as “attention seeking”
Lack of engagement is often seen by clinicians as being due to mental illness when it may be practical everyday things that get in the way
Symptoms of mental health disorders themselves make communication difficult
Disrespectful, non-caring behaviour by both mental health and general clinicians
Having no advocate
Feeling powerless
Ambivalence – too often we accept the persons view that they are stigmatised and the result is that we don’t meet their health needs met
What tools to we have to address these issues?

Recovery-oriented practice: the National recovery-oriented mental health practice framework

“Starting with the initial assumption that personal recovery is different for everyone, ‘personal recovery’ is defined within this Framework as being able to live well and to build and live the life one chooses in the presence or absence of mental ill health”

http://www.crazelateralsolutions.com

John also argued that clinicians will have more influence by “giving up” coercive power-assertive tactics, both over colleagues and consumers/patients.

John suggested making people with severe mental illness a special target for all governments, with specific, hard indicators of success. With these few simple indicators, practice and policy will shift to meet them.

Reduce smoking rates to general population levels
Reductions in average HBA1C concentrations to less than 7% among consumers with severe mental illness (HBA1C is a form of haemoglobin that gives a measure of the average concentration of glucose in the blood over a long period of time)
Increase of cancer treatment rates to the level in the general population
Education and awareness and training: for example enabling all psychiatrists to prescribe statins
 John suggested a number of steps that will help:

Adopt a recovery paradigm
Target for peer support workers
Equal go for people with severe mental illness in the NDIS
Self-management, life coaching, advocacy
Further information and resources 

The Concord Centre for Cardiometabolic Health in Psychosis

http://ccchip.com.au/

The National recovery-oriented mental health practice framework

 www.crazelateralsolutions.com

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