New mental health roadmap to stop the 23 year death gap

A new report from 60 leading Australian health experts recommends major improvements to primary healthcare services in Australia to stop people with serious mental illnesses from dying between 14 and 23 years earlier than other Australians.

Nearly 80% of people with serious mental illness die prematurely of chronic physical health conditions that could be effectively managed and often prevented.

The Federal Health Minister Greg Hunt launched the Australian Health Policy Collaboration’s (AHPC) Being Equally Well Roadmap (PDF, 561.63 KB) report. Developed in partnership with GPs, psychiatrists, mental-health consumers and carers, and other health professionals, the roadmap lays out changes to how medical services can work, including:

• implementing shared care between psychiatrists and GPs, and with pharmacists to manage mental and physical health together
• mental health nurse navigators, to support people in navigating the complex health system
• Medicare Benefits Scheme funding for GPs to set up dedicated supports to ensure regular health checks and screening as well as treatment of chronic conditions
• ending gap payments for medication, including for cardiovascular diseases risk reduction medication and nicotine patches
• establishing a federally funded national clinical quality registry to support and monitor improvements in life expectancy for people with serious mental illnesses and
• establishing a national Office for Quality in Physical and Mental Healthcare Outcomes.

Professor Rosemary Calder from Victoria University’s Mitchell Institute and AHPC lead said if implemented the roadmap would help more than 470,000 Australians with a serious mental illness live longer and healthier lives.

“Change is needed to address the shocking reality that people with severe mental illness die up to 23 years earlier than the rest of Australians,” Professor Calder said.

“Our current health system is largely designed and structured to treat health conditions separately and health professionals often prioritise mental health illness over physical health. There is also a persistent element of bias – with mental illness sometimes seen to be the explanation of other illnesses or conditions.

“We need better health system arrangements that prioritise and support both the physical and mental health of people at the same time.”

Professor Calder said this roadmap shows the way to supporting joined-up care between mental health services and general practice.

“Delivering a shared-care model of health care will ensure the whole person is treated and physical healthcare is given the priority it should command alongside mental-health care,” she said.

People with severe mental illness are six times more likely to die of cardiovascular disease, five times more likely to smoke and die of a smoking-related illness, and four times more likely to die from respiratory disease.

Professor of Psychiatry at the University of Melbourne Malcolm Hopwood said:

“I am horrified to think that the next patient I see with a major mental illness will die up around 20 years younger than the rest of the Australian population. It is simply unacceptable.”

“The suite of measures in this roadmap offers an evidence-based way forward and demands government and healthcare sector support.”

Consumer experience

Fay Jackson said change was urgently needed in healthcare delivery and support for people with severe mental illness.

Fay was suffering neurological, kidney and weight problems associated with long-term use of a medication to treat bipolar schizoaffective disorder.

In her 50s, with the support of her GP, a general physician and pharmacist working together, she was able to transition off the medication, a step which transformed both her physical and mental health.

“I have lost 11 kilos. I am no longer pre-diabetic, my bad cholesterol has dramatically dropped, my doctors have indicated that my heart disease risk has shifted from high-risk to low risk,” Ms Jackson said.

“My mind and memory are clearer, my energy levels have increased, I am exercising every day and my relationships with the people I love have improved.”