Addressing the physical health of people living with mental illness
By Gabrielle Maston, Dietitians Association of Australia
Thursday, 27 July, 2017
The statistics are dire when it comes to the average life span and quality of life of people living with mental illness. Australian research shows that those living with a serious mental health condition can be two to three times more likely to suffer from type 2 diabetes and four times more likely to have cardiovascular disease1,2. They also have double the mortality risk of the general population3.
People living with mental illness need to take care of their physical health through healthy eating and exercise, just like everyone else. Perhaps more so, given their increased risk of chronic disease and multiple confounding factors that contribute to poor health. These include excessive weight gain due to psychotropic medications, lack of motivation, drowsiness and fatigue arising from medications or caused by the condition itself. Due to these factors, low levels of physical activity, substance abuse and poor eating patterns can occur, further impacting on physical health.
Addressing chronic disease prevention in this cohort can be challenging. They are often stigmatised, can be poor at keeping appointments, inconsistent with behaviours and dismissed as time wasters. But with a little persistence, empathy and patience, people living with mental illness can move leaps and bounds with their physical and mental health.
By improving diet and exercise, side effects and complications of these chronic conditions can be reduced. Accredited Practising Dietitians (APDs) and Accredited Exercise Physiologists (AEPs) are best placed to provide this support.
To complement diet and exercise advice, psychologists can provide evidence-based psychological interventions for mental health conditions, as well as helping people change their lifestyle behaviours that contribute to lower quality of life and chronic disease.
These allied health professionals are well placed to provide patient centric care, which focuses on behaviour change that utilises motivational interviewing skills to provide the most benefit for patients. They are also well placed to provide long-term treatment, which can follow a patient throughout different phases of life. This enables practitioners to provide support and consistent monitoring. A referral to one practitioner could be an important gateway to achieving access to a range of health services that addresses all areas of their life.
Medicare has several pathways to care through allied health professions which can assist patients living with mental illness to improve their physical health. This includes 10 visits to a psychologist under a Mental Health Plan and/or a referral to an Accredited Practising Dietitian and Accredited Exercise Physiologist under a Chronic Disease Management Plan for a further five visits.
In recognition of the importance of integrated, holistic healthcare for people living with mental illness, the Dietitians Association of Australia, Exercise & Sports Science Australia and the Australian Psychological Society have issued the joint position statement ‘Addressing the physical health of people with mental illness’.
The statement stresses that strong referral networks and collaboration between health professionals within the mental health treatment team are needed. It also underlines the importance of diet and exercise, along with psychological treatment and medical treatment, for people living with a mental health disorder.
To access the statement, check out the Dietitians Association of Australia’s media release page from March 2017.
- Australian Health Policy Collaboration, The Costs and Impacts of a Deadly Combination: Serious Mental Illness with Concurrent Chronic Disease. A Policy Issues Paper for: The Royal Australian and New Zealand College of Psychiatrists. 2016.
- Morgan, V, et al., National survey of people living with psychotic illness 2010, in Commonwealth of Australia 2011: Canberra.
- Walker, E., McGee, R. and Druss, B., Mortality in mental disorders and global burden of disease implications. A systematic review and meta-analysis. JAMA Psychiatry, 2015. 72(4): p. 334-41.
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