Joe Parks, MD
Director Missouri Medicaid
Alarmingly, people with severe and persistent mental illnesses die about 25 years earlier on average than the general population.
Factors like suicide seem like a possible reason since the rate is much higher in this group than the general population, but in fact, heart disease as a cause of death in this group is about 5 times more common than suicide. While rates of cardiovascular death have been declining (at a younger age) in the general population over recent decades, it has been increasing for people with severe mental illness. Furthermore, rates of physical illness are higher in general for people with severe mental illness than non-severe mental illness in general.
It obviously makes sense to address these issues from a wellbeing perspective. What about a financial perspective? Well, the cost of the providing health care for people with a mental disorder is about 2-3 times higher than people without a mental disorder. The bulk of those costs are not for psychological treatments, they are for the physical treatments.
Where are these additional health concerns coming from?
For the most part: Smoking, obesity and inactivity - some of which can be contributed to by the treatments provided (e.g. medication and culture in treatment settings).
There are guidelines for monitoring patients on antipsychotic medication which suggest that many physiological factors should be monitored, but these are not mandatory so they often don’t get done. Ultimately these additional health concerns don’t get treated. They need to be if we’re to help people recover from serious mental illness.
In summary, I felt like the message was that what is needed is better-coordinated and holistic care. This message complemented Pat Dudgeon's presentation yesterday about the need for wholistic conceptions and responses to wellbeing.
And because I found these amazing but didn’t know where to put them in… here’s some additional facts that I found striking:
- 44% of cigarettes in the US are smoked by people with a mental illness.
- People on more than one antipsychotic medication are 2.5 times more likely to die than a person only taking one… and we don’t know why.