'Scandal' of shortened lives of mentally-ill

Mental ill-health linked to higher risk of serious illnesses

People with serious mental illness are still living 15-20 years less than the rest of the population, according to a study from the Nordic countries.

The findings have been described as a "scandal" by a British psychiatrist and led to calls for better provision of healthcare for those suffering from mental ill-health.

Researchers from the Nordic Research Academy in Mental Health in Sweden studied the life expectancy of people admitted to hospital for a mental disorder in Denmark, Finland and Sweden between 1987 and 2006. They found that those with a mental disorder had a two-to threefold higher mortality than the general population in all three countries.

The researchers, led by Professor Kristian Wahlbeck, suggest several explanations for the higher mortality rate among people with mental disorders, including an unhealthy lifestyle, inadequate access to good quality physical healthcare, and a culture of not taking physical disease into consideration when treating psychiatric patients. Professor Wahlbeck also pointed out that people with mental illness are more often poor, unemployed, single and marginalised, "all known risk factors for poor health and premature mortality".

Writing in an editorial in the same issue of the British Journal of Psychiatry, Graham Thornicroft, professor of community psychiatry at King’s College London, said the findings denote a "cynical disregard for these lost lives".

"It shows, in stark terms, by just how much people with mental illness are valued less than others in our society," he said.

"Even in three Scandinavian countries that provide among the best quality and most equitably distributed healthcare in the world, this mortality gap has narrowed only by a modest extent over the past two decades and remains stubbornly wide," he said. "There is now strong evidence that people with mental illness receive worse treatment for physical disorders. Medical staff, guided by negative stereotypes, often tend treat the physical illnesses of people with mental illness less thoroughly and less effectively."

Although there are differences between the Nordic countries and the UK (Finland and Sweden have the 14th and 15th highest suicide rates in the world, compared to the UK which is ranked 46th), research has shown that people suffering from serious mental illness die earlier than the general population, largely because of physical health problems. Mental ill-health is linked to increased risk of chronic diseases including cancer, heart disease and diabetes. Conversely, poor physical health increases the risk of people developing mental health problems.  

"If such a disparity in mortality rates affected a less stigmatised section of the population, then we would witness an outcry," said Professor Thornicroft.

NHS data shows that the number of people using NHS mental health services rose by 1.2% this year, to about one in 36 people. However, the proportion of these people who spend time in an NHS hospital has been declining from 10.5% in 2004 to 8.1% this year. A recent report for the Centre for Social Justice called for a revolution in mental health care in the country, raising concerns that there is inadequate support for people in the community.

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