MIND
August 1, 2019

Mental Illness, Physical Illness

The medications used to relieve the symptoms of psychiatric disorders tend to raise the risk of obesity and heart problems. Doctors need to treat body and mind.

People with mental illness have physical problems, too, often as a side effect of the drugs they take for their mental disorders. In order to help them live longer lives, healthcare providers will have to pay more attention to their physical health problems, a Lancet Psychiatry Commission report finds.

“One in five people across the world live with mental illness and people with mental illness can die up to 18 years earlier than the general population,” Commission member, Dan Siskind, said in a statement. “Contrary to popular belief, this is not because of suicide. It is from physical health issues associated with mental illness like diabetes, cardiovascular disease and lifestyle factors.”

People with mental illness are twice as likely to have diabetes as other people are.

Antipsychotic drugs may be effective at treating some mental health problems, but they often bring on substantial weight gain or even obesity.

The commission recently published a blueprint of practical strategies to address this oversight. Central to the blueprint is the idea of psychiatrists, therapists and other mental health specialists helping their patients gain greater access to primary care.

Even people without mental health disorders can find it daunting to run the gauntlet needed to see their physician. Mental health problems, such as depression or anxiety, make doing this even more difficult. From information about healthy lifestyle changes to checkups that screen for side effects from the medications they are taking, many mental health patients need additional access to primary care physicians.

Many physical health problems can be treated or prevented before they develop by lifestyle changes, such as quitting smoking, becoming more physically active or eating a healthier diet. The conversations that start people down this road often come during visits to primary care doctors.

Some mental health patients also face physical health problems from side effects of the medications they are prescribed, particularly among those who take antipsychotics. While effective at treating some mental health problems, these medications often lead to substantial weight gain or even obesity. People who take these medications require additional monitoring. Antidepressants, which are much more common, can also have side effects.

Along with mental health professionals helping their patients access primary care treatment, Siskind envisions a “one-stop-shop,” where patients can have both their mental health and physical health needs met/treated by a team of experts.

“This is about making everyone realize patients are whole people,” says Siskind, an Associate Professor at the University of Queensland in Australia. “It's not just about eradicating mental health problems; we need to look after physical health too.”

The blueprint appears in The Lancet Psychiatry.

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