Report reveals extent of poor physical health among people with mental illness

Findings released today in a special commissionfrom The Lancet Psychiatry reveal the extent of physical health inequalities experienced worldwide by people with mental illness.  The commission urges immediate action to tackle the situation and outlines ways to address this pressing issue.

The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness’ is the culmination of over 12 months of research conducted by a taskforce of more than 30 international experts, including researchers from King’s College London. 

The researchers found that a broad range of mental illnesses are associated with a lifelong burden of obesity, diabetes, cardiovascular disease, stroke and other physical conditions. This burden contributes to a gap in life expectancy of around 20 years for people with mental illness, compared to those without, and this gap may be increasing.

Higher rates of smoking, sleep disturbance, physical inactivity, unhealthy diet, the side-effects of psychiatric medications, and a lack of access to adequate physical healthcare were all found to be contributing factors.

The researchers make a number of recommendations, including:

• Further research to mitigate the cardiometabolic side-effects of psychotropic medication.
• Better integration of physical and mental healthcare.
• Lifestyle interventions to pre-empt physical health conditions and prevent them from developing.
• Research councils must allocate funding to address the physical health disparities affecting people with mental illness, that is at least as much as the demonstrated financial cost of physical and mental comorbidities.
• Governments must address the inequalities in health insurance and access to care for people with mental illness. 

The report also highlights the potential of digital health technologies to help reduce physical health disparities for people with mental illness, stressing that rigorous evaluation of their benefits and limitations will be necessary.

Dr Brendon Stubbs, co-senior author of the Commission and NIHR Clinical Lecturer at the IoPPN, said, ‘The leading cause of early death in people with mental illness is poor physical health. This is often caused by entirely preventable health conditions. Through this commission, we have set out ambitious goals to provide an opportunity and directions to help people with mental illness improve their physical health, and not only add years to their life, but also add life to their years. 

‘In order to achieve this, we need approaches that are collaborative, multidisciplinary and service user-focused, and that place lifestyle interventions as a core preventive and management strategy.’

Chair of the Commission, Dr Joseph Firth, senior research fellow at NICM and honorary research fellow at the University of Manchester, said: ‘Patients with serious mental illness are two to three times as likely to have obesity, diabetes and cardiovascular diseases, which impact on quality of life and recovery, while contributing towards a 20 year gap in life expectancy currently experienced by this underserved population.

‘These comorbidities begin to arise early on and affect people with mental illness across the entire lifespan. Clearly, protecting the physical health of people with mental illness should be considered an international priority for reducing the personal, social and economic burden of these conditions.’

Dr Fiona Gaughran, co-author of the report and Reader in Psychopharmacology and Physical Health at the IoPPN, features in a podcast on the The Lancet Psychiatry website, where she summarises some of the wide-ranging findings and recommendations of the commission, highlighting the need to think of both body and mind from the moment a person first presents to mental health services.  

Dr Gaughran said ‘The physical health disadvantage experienced by people with mental illnesses can be profound and its causes are multiple. This commission highlights ways in which clinicians and healthcare systems can flexibly meet the physical health needs of people with mental illnesses. We hope that this will guide clinical practice, preventative strategies and service provision.’

Reference

‘The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness’, Firth et al, The Lancet Psychiatry, doi: 10.1016/S2215-0366(19)30132-4

Contact

For interviews or any further media information please contact: Robin Bisson, Senior Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, robin.bisson@kcl.ac.uk / +44 20 7848 5377.