Simplify our health system to cut 20 year mental health life expectancy gap

The 20 year gap in life expectancy for people with severe mental illness could be slashed if health services for both physical and mental health connected around the people who need them.

Australia’s health experts are attending a national symposium in Parliament House today to develop a comprehensive and achievable policy to reduce preventable early deaths among people with mental illness.

More than 11,000 Australians living with mental illness die prematurely each year.

Suicide accounts for less than one in 10 early deaths, with the remainder due to poor physical health.

However, people with mental illness are 50% less likely to receive treatment for their physical illness with the complexity of the system, segregation of mental health services and healthcare workers more likely to overlook physical health concerns, all barriers to treatment.

Professor Rosemary Calder from Victoria University’s Mitchell Institute and leads the Australian Health Policy Collaboration said 4.8 million Australians were living with a mental illness and half of those also had a physical chronic illness.

"For people living with mental illness, maintaining physical health can be more challenging. Our health system is too complex to navigate and does not provide arrangements and services to treat the whole person, instead focusing on individual illnesses and sending people to different specialists to treat each illness,” she said.

There is little to no support for treating underlying physical health risks before they lead to preventable chronic illness, particularly for people with mental illness who are at much higher risk of experiencing both.

“Our traditional models of health care mean that people with mental illness can miss out on opportunities to help treat and manage their physical health which puts their mental health at risk and contributes to their high risk of early death associated with preventable chronic illness.”

Data from Australia’s Mental and Physical Health Tracker shows that, compared with the general population, people living with mental health conditions are:

• over 40% more likely to report having circulatory system diseases, including CVD and stroke
• almost 60% more likely to report having diabetes
• about 70% more likely to report having chronic back pain
• over 55% more likely to report having arthritis
• more than twice as likely to report having chronic obstructive pulmonary disease
• between 20% (females) and 82% (males) more likely to report having cancer
• two and a half times more likely to smoke.

"Our healthcare arrangements are siloed into separate services for physical and mental health, as well as separate services for different physical health conditions," Prof Calder said.

“For people with severe mental illness, these silos often mean there is little focus on boosting physical health and few mechanism to support patients, despite strong evidence that people’s mental health can be improved through physical activity and healthy diets.”

RANZCP estimated the cost of premature death of people with both physical health conditions and severe mental illness is $15 billion per year. When the cost of substance use is included, this increases dramatically to $45 billion.

People with severe mental illness are:

• six times more likely to die from cardiovascular disease
• four times more likely to die from respiratory disease
• three to four times more likely to die prematurely
• two to four times more likely to die from infectious diseases.