Physical health of patients with enduring mental illness
Sir, – We read with interest Dr Muiris Houston’s column “A stark inequity: People with severe depression, schizophrenia die 10 to 25 years earlier” (Health + Family, December 11th).
We thought it would be timely to bring your attention to research that the Irish College of General Practitioners (IGCP) has undertaken since 2016, in collaboration with the HSE on the physical health of patients with enduring mental illness.
Mental illness can act as a barrier to accessing and obtaining effective medical care, and is associated with increased medical morbidity. People with enduring mental illness have higher morbidity and mortality from chronic diseases than the general population, and this results in a significantly reduced life expectancy.
As stated in Dr Houston’s column, the majority of these premature deaths are due to physical health conditions.
The overall aim of the study was to develop and assess a standard protocol to aid the health professional in the monitoring and treatment of the physical health of patients who have a severe mental health illness presenting in general practice/primary care.
Papers from this work are currently awaiting publication but to date, the preliminary results indicate that in fact Irish GPs record the physical health parameters for patients with enduring mental illness more often than for the general adult population consulting in general practice. We considered this a very positive and heartening finding.
However, improving physical health for this patient group takes considerable time, needs to be introduced step by step and requires sustained effort. In a matched age/gender analysis, we found that in line with international findings, patients with enduring mental illness are more likely to be current smokers than patients with diabetes or patients with no known chronic illness. It is in targeting such issues that general practice needs to be supported by the wider healthcare system.
Patient safety is more at risk when patients cross boundaries of care and so it is crucial that clinical responsibility, accountability and integration are established. The evidence from this work could form the basis for innovation and change in practice and inform future service delivery in Ireland for people with enduring mental health illness. – Yours, etc,
Dr BRIAN OSBORNE,
Assistant Medical Director,
CLAIRE COLLINS, PhD,
Director of Research,
Irish College of General