by David Shern, PhD
President and CEO, Mental Health America
According to a 2006 report from the National Association of State Mental Health Program Directors, people with serious mental illnesses, including schizophrenia, die at least 25 years earlier than the general population, largely due to preventable medical conditions, such as diabetes, cardiovascular disease, and respiratory and infectious diseases. Nationwide, rates of chronic illnesses, such as heart disease and diabetes, are at epidemic levels. Nowhere is this public health dilemma more evident than in people with serious mental illnesses who die at nearly twice the rate of the rest of the population from heart disease and diabetes.
In January, 2008, Mental Health America released results of the first national online survey to examine overall healthcare in mental health settings from the perspective of both people with schizophrenia and psychiatrists. Survey results showed that although both groups are aware of actions to improve overall health and quality of life, they are not discussing such actions to the extent possible.
While 40 percent of survey respondents have private health insurance, they still report significantly higher rates of chronic illnesses than the general population. Forty-four percent and 23 percent of all respondents reported being obese and having diabetes, respectively, compared to 26 percent and eight percent of the general population. Survey findings include:
• While many psychiatrists report asking or discussing general health issues with their patients, 83 percent of psychiatrists cited lack of time during patient visits as the main obstacle to providing overall care; 74 percent feel they are not as well-equipped to address patients’ overall health as are primary care physicians.
• Eight-two percent of consumer respondents feel that treatment of their overall health—not just their mental illness—is important to their recovery. Yet nearly half expect their psychiatrist to focus exclusively on their mental health (48%), rather than overall and mental health.
The survey also points to significant concerns about medication side effects. Experts suggest that some commonly used mental health medications, namely second-generation atypical antipsychotics, which are associated with weight gain and other side effects, may be putting people with schizophrenia at a much greater risk for obesity and diabetes. The survey found that:
• Sixty-nine percent of people with schizophrenia reported that they have discontinued use of medication due to side effects that negatively impacted their quality of life. Almost 40 percent of consumers reported that the longest they had continuously remained on one medication was less than a year.
• When choosing from a list of side effects considered when prescribing antipsychotic medication, diabetes was most often cited by prescribers, with 94 percent of psychiatrists considering it “extremely” or “quite” important.
The take-away message of the survey is that mental health providers and people with schizophrenia must communicate more about issues like diet, exercise, and medication side effects if we are to turn the tide of this public health crisis and extend the lives of the millions of Americans with schizophrenia. Psychiatrists and other mental health professionals should intensify their efforts to protect the health and promote the wellbeing of their patients with schizophrenia.
About the Survey
“Communicating About Health: A Mental Health America Survey of People with Schizophrenia and Providers” was conducted by International Communications Research. Consumer surveys were conducted online between September 17 and October 12, 2007, among a sample of 250 adults with schizophrenia (ages 18 years and older) who had been diagnosed by a qualified medical professional as a person with schizophrenia and 250 psychiatrists. The group of consumers was provided by an online research panel that maintains a nationwide sample of respondents and rigorously checks the quality and validity of the sample. Average age of consumer respondents was 38, with a majority being female (56%), Caucasian (76%), employed—paid or unpaid—(52%), and from various incomes and geographic regions.
Physician respondents comprised practicing psychiatrists who treat people with schizophrenia and are members of a national, verified online research panel. Average years in practice for physician respondents was 12, with a majority being male (69%) and seeing 11 or more schizophrenia patients each month (81%). Respondents were from various geographic regions and worked in public, private, and integrated health settings. The margin of error for the survey is ±6.2 percent.
For more information on the survey, including methodology, visit www.mentalhealthamerica.net.