Patients with schizophrenia will on average die 14.6 years earlier, bipolar 10.1 and patients with schizoaffective disorder eight years earlier than the general population. They are dying of the same conditions as the general population but have the life expectancy of people living in the 1950s.
As the Department of Health launches its Mental Health Action Plan, NHS England is setting out how it will tackle a number of mental health issues. This includes the health inequalities between people with serious mental illness and the general population.
There are more than 40,000 deaths among people with serious mental illness which could be reduced if they receive the same healthcare checks and interventions as the general population.
Statistics show that patients with serious mental health conditions such as schizophrenia, bipolar disorder and other psychoses are dying earlier from conditions such as cardiovascular disease, cancer, lung disease and liver disease.
This is because the physical health risk factors of these conditions are not being managed as well in these patients who are missing out on vital health interventions.
Dr Geraldine Strathdee, NHS England’s National Clinical Director for Mental Health, said: “We are keenly aware of the issues patients with severe mental illness have in terms of their physical health, and the need for extra help to tackle their physical health problems.
“Patients with schizophrenia will on average die 14.6 years earlier, bipolar 10.1 and patients with schizoaffective disorder eight years earlier than the general population. They are dying of the same conditions as the general population but have the life expectancy as people had living in the 1950s.
“In all inpatient units and three community intensive teams, we want to make sure health professionals across the board are making checks which pick up lifestyle issues such as smoking and lack of physical exercise which are markedly higher in the SMI population than the general population, as well as tackling the higher levels of diabetes, cancer and other long-term illnesses. We know that medication can be a factor, so people also need to be offered regular education, choice and monitoring of the impacts of medication.
“This needs a coordinated effort so that some organisations which traditionally solely address the patient’s psychological problem, also now arrange treatment of the physical health aspects. We urge those leading organisations which have made major progress in recent years in tackling the neglect of physical morbidity to share learning with others
“People with serious mental illness (SMI) often do not respond to health messaging campaigns, such as ‘be clear on cancer’, in the same way as the general population and therefore there needs to be a real focus to increase awareness, educate and implement forms of outreach to this vulnerable group. Everyone has a part they can play, and we are working with partner organisations representing service users, families and carers, committed mental health clinicians, Royal Colleges, commissioners and GPs to drive improvement.”
Supports for implementation are being developed by NHS England and its partners which could make a real impact on reducing the premature mortality that exists in the serious mental illness population.
- Using a best practice model which will pick up patients with SMI who have physical health conditions that need assessment and treatment. NHS IQ are implementation supports
- Working closely with experts in medicines management to ensure the effects and side effects of psychotropic medications are routinely monitored and addressed
- Introducing incentives for physical health checks and treatments to be undertaken in all mental health inpatient settings of all types, in all sectors (a new national CQUIN)
- Developing advice from successful best practice schemes about how to educate staff and patients to achieve smoke free inpatient settings and stop smoking
- Working with public health and commissioners so targeted smoking schemes for people with mental health issues are commissioned
- Assessing the evidence about what works in reducing premature mortality and ensuring this information is disseminated across the NHS particularly to CCGs and strategic clinical networks.
Dr Strathdee added: “While this year we are targeting patients in all inpatient settings and the three community teams, we want to learn from this, and in the future identify how to use the successful improvement methods for all mental health service users in contact with Primary care and mental health teams in the community.
“We must make sure we tackle the higher levels of mortality and reduced life expectancy in patients with mental illness and we are committed to pushing mental health to the top of the NHS agenda.”
NHS England is absolutely committed to working towards Parity of Esteem through a key programme that aims to value physical health the same as mental health so those with a mental health condition can get the same access to healthcare services as they would for physical health and vice versa.
Early priorities for Parity of Esteem include:
- Improving access to Psychological Therapies
- Improving diagnosis and support for people with dementia
- Improving access to care in crisis
- Improving mental health information and intelligence
- Improving the physical health of people with serious mental illness
Jo Powell, NHS England’s programme lead for the Parity of Esteem programme, added: “The programme aims to prevent and detect long-term physical and mental health conditions earlier, and ensure timely access to high quality services for people with mental health needs, among many other things.”