Managing Physical Health in Mental Health Populations

People with serious mental illness (SMI) have greatly increasing morbidity and mortality from physical illness than the general population. This results in a 25 to 30 year shorter life expectancy with cardiovascular disease being the leading cause of death 1. It has been suggested that current policy, services and health promotion actions are ineffective in targeting physical illness in this population. Vulnerabilities for Physical Health Difficulties Excess mortality seen in the psychiatric population reflects multiple vulnerabilities and risk factors including poverty, unemployment, being single and marginalised have been reported. Lifestyle risks include a poor diet, increasing smoking and substance abuse rates and lower levels of exercise 2. Although there may be a genetic predisposition to develop metabolic abnormalities in schizophrenia, the impact of negative symptoms of illness such as difficulties in concentration and memory and a lack of motivation is also significant 3. This is compounded by the finding that people with mental illness have inadequate access to good quality physical healthcare and that they receive poorer treatment for physical disorders (âdiagnostic overshadowingâ) than the general population 4. The potential of antipsychotic medications to cause significant weight gain and other metabolic side effects leaves this population at high risk of physical illness. Targeting Physical Healt