Mentally Ill Have Significantly Reduced Life Expectancies
> 5/3/2007 11:40:06 AM

A disturbing new report that has emerged from a meeting of state hospital directors from around the country estimates that the life expectancies of patients suffering from some form of mental illness who are treated in public facilities are a shocking 25 years below the national average. Even more discouraging is the fact that this number has risen by at least ten percent in the last decade alone. Our healthcare system's current approach to combating mental illness is clearly not working.

It's a well-established fact that patients suffering from mental illness are much more likely to encounter problems with obesity and substance abuse, and their suicide rates are understandably higher than average. But they are also several times as likely to die in accidents or from common afflictions like diabetes, heart disease, and respiratory failure. Some of these alarming stats stem from the physical repercussions of antipsychotic medications, which have a long history of contributing to weight gain, blood sugar problems and cardiovascular disease, particularly among those who, like many of the same patients, live sedentary lifestyles involving risk factors such as smoking, unfit dietary habits and excessive alcohol consumption.

One of the other major problems contributing to this epidemic is the lack of public, integrated care incorporating the simultaneous services of both physical and mental health professionals. It makes very good sense that schizophrenic patients with heart disease or diabetes, for example, should optimally receive their care in a single location, not only for convenience but because they are less likely to receive sufficient treatment if required to shuttle between facilities. Appointments are also reportedly harder to come by for patients whose illnesses, in their most severe forms, can render them incapable of acting in their own self interests (or at least reduce their capacity to do so). The causal relationship between physical symptoms and mental illness is often less than clear, but some practitioners still downplay the physical ailments of patients suffering from crippling depression or related disorders (or vice versa). The two cannot be effectively separated, and we should clearly move toward treating them simultaneously. Improvements in one's mental state will almost certainly lead to better physical conditioning, and the cycle will, in the best cases, continue to reinforce itself.

The problem is not that mentally ill individuals have gotten worse. It's that we have not adapted fully or quickly enough to address their needs, particularly in the public sphere. For the many who must work and receive treatment under this system, the news is not particularly good. Andrew Leuchter, director of the UCLA school of medicine, puts it very simply:

"The public health system is underfunded, and it's gotten worse over the years."

Colleague Joseph Parks of the Missouri Department of Mental Health is equally frank:

"We're going in the wrong direction and have to change course."

One cannot place the blame entirely on the patients themselves. Our country is clearly neglecting the needs of the millions of citizens whose everyday lives are adversely affected by some form of mental illness in the name of saving money (or at least a pronounced reticence to entertain ideas of increased research and funding for the 60% of mental health patients who cannot afford private care.) These problems are not going away. Their influence is growing, and the numbers cited by this report indicate that the expansion is rapid. For the long-term health of the American people as a whole, any notable investment of money, resources and manpower will be worth it.

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