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MEDIA BRIEFING: Mental illness takes a toll on the body and years from your life: 20 year life expectancy gap revealed

Embargoed until: Publicly released:

People suffering from mental illness face drastic physical health challenges too, according to an Aussie-led task force which found people with mental illness could experience a gap in life expectancy of around 20 years. The report found a broad range of mental illnesses are associated with a lifelong burden of obesity, diabetes and cardiovascular disease, and makes a range of lifestyle and healthcare recommendations to combat the huge disparities faced by these vulnerable populations. Tune into the briefing to hear from the lifestyle lead Dr Simon Rosenbaum and Commission Chair Dr Joseph Firth, who describes these disparities as a “human rights scandal”.

Journal/conference: The Lancet Psychiatry

DOI: 10.1016/S2215-0366(19)30132-4

Organisation/s: Western Sydney University, The University of New South Wales, The University of Melbourne, The University of Queensland, Deakin University

Funder: This work was supported in part by the National Institute of Health Research (NIHR) using Official Development Assistance funding (Grant: 17/63/130: NIHR Global Health Research Group: Improving Outcomes in Mental and Physical Multimorbidity and Developing Research Capacity (IMPACT) in South Asia at the University of York). JF is supported by a Blackmores Institute Fellowship. NS is funded in part by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH). DSi is supported in part by an NHMRC Early Career Fellowship (APP1111136). SR is supported by an NHMRC Early Career Fellowship (APP1123336). FG is funded in part by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. FG is also supported by the Maudsley Charity, King’s College London, and the South London Collaboration for Leadership in Applied Health Research and Care Funding. JS is supported by an NHMRC Clinical Research Fellowship (APP1125000). JTo is supported by a NARSAD Young Investigator Grant from the Brain and Behavior Foundation. Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs is also supported by the Maudsley Charity, King’s College London and the NIHR South London Collaboration for Leadership in Applied Health Research and Care (CLAHRC) funding. GT is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College London NHS Foundation Trust, and the NIHR Asset Global Health Unit award The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. GT receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT is supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. The views expressed in this Commission are those of the authors and not necessarily those of the acknowledged institutions.

Media Briefing/Press Conference

From: Australian Science Media Centre

Speakers:

  • Dr Joseph Firth is the chair of the commission and senior research fellow at NICM Health Research Institute, Western Sydney University and honorary research fellow at the University of Manchester
  • Dr Simon Rosenbaum is the lifestyle section lead of the commission, and scientia fellow and NHMRC research fellow at UNSW Sydney.

Date: Mon 15 July 2019
Start Time: 10:00am AEST
Duration: Approx 45 min 
Venue: Online

This briefing has now finished. If you would like to see the recording, you can find the link below.

Attachments:

  • Australian Science Media Centre
    Web page
    Briefing recording

Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Max Abbott, Professor of Psychology and Public Health, and Co-director, National Institute for Public Health and Mental Health Research, AUT

The report findings are not a surprise. Accumulating research from around the world indicates that people with mental health and addiction disorders have a much higher risk of physical illness and reduced life expectancy. Links with obesity, diabetes and cardiovascular disease are particularly strong. In the case of severe mental health disorders, life expectancy is reduced by 20 to 25 years. New Zealand is no exception and this was highlighted in a 2014 Te Pou report and the recent Government Inquiry into Mental Health and Addiction. The reasons for reduced life expectancy include high rates of smoking and other drug use, unhealthy diet, lack of physical activity and side effects of medication, particularly antipsychotics. Suicide rates are also higher. Lack of access to comprehensive physical and mental health services is another major factor. While largely omitted from the Lancet report, stigma and discrimination, poverty, unemployment, housing problems, social isolation and residence in high deprivation, obesogenic neighbourhoods are undoubtedly also important.

These high rates of physical health morbidity and greatly reduced life expectancy are totally unacceptable. While this matter has received increased attention in recent years, measures to prevent and reduce these iniquities need to be massively amplified. It is essential that physical and mental health are given equal consideration from the time of first contact with health services. Hopefully the Lancetreport will help mobilise global efforts to address this too-long neglected issue. The report reviews relevant research and outlines measures capable of significantly improving the physical health and wellbeing of people experiencing mental health disorders.

This Government has committed to transforming mental health services in this country, supported by additional funding of almost $2 billion over the next four years.This provides a unique opportunity to address the need and massive challenge presented in this important and timely report. However, health service transformation and individual behaviour change, while essential, will be only partially successful if major economic, social and environmental health determinants are not also addressed. Other Government commitments, reflected in the recently announced Wellbeing Budget, are highly relevant. The Budget includes measures intended to reduce poverty and a range of social and health disparities.

Last updated: 16 Jul 2019 2:45pm
Declared conflicts of interest:
None declared.
Dougal Sutherland, Clinical Psychologist, Victoria University of Wellington

The phrase “there’s no health without mental health” is starkly demonstrated in findings released today by a taskforce of international experts. The report from the Lancet Psychiatry Commission found that people with mental health problems are up to twice as likely to suffer from obesity, diabetes, and cardiovascular disease and are at risk of dying 20 years earlier than those without a mental illness. The report’s authors note that despite the link between mental health and physical health having been known for decades little has been done to address the issue, a failure which the authors rightly refer to as “human rights scandal”.

Drawing together research from the past two decades the Commission’s report highlights key risk factors linking mental and physical health including higher rates of smoking, poor sleep, diet, and physical activity, and medication side-effects. The report also reveals that people with mental health problems are often not given access to physical healthcare that they need, due partly to bias and lack of training of healthcare professionals.

The report gives support to the rationale behind the New Zealand Government’s recent Wellbeing Budget which recognised the relationship between social factors, such as poverty, and mental health. The Commission’s report may also help us understand why in New Zealand Maori and Pasifika people are over-represented in both negative mental and physical health statistics as these two areas are tightly intertwined.

Addressing the health inequities suffered by those with mental health difficulties requires a revolution in the way healthcare services are delivered and how healthcare professionals are trained. We need to break down the artificial distinction between physical and mental health which currently underpins our hospitals and medical practices, a call which was recently made in He Ara Oranga the report of the Government Inquiry into Mental Health and Addiction. Medical professions need to have a greater understanding of mental health, and mental health professionals need more training and education in the basics of physical health. The Lancet Psychiatry Commission also recommends that clinicians and researchers use advances in digital health technologies to bridge the gap in the physical wellbeing of people with and without mental health problems.

The lead authors of today’s study point out that many of the physical illnesses suffered by those with mental health problems are preventable and that as a society we must address this inequity to “not only add years to [the] life, but life to [the] years” of those with mental illness.

Last updated: 16 Jul 2019 8:59am
Declared conflicts of interest:
None.
Professor Rod Jackson, cardiovascular disease epidemiologist, University of Auckland

The findings of the Commission are in line with our review of the literature and local data in regard to the increased risk of cardiovascular disease (CVD) in people with mental illness. Chronic disease, particularly CVD, accounts for a substantial proportion of the reduced life expectancy in people with severe mental illness. Our preliminary analyses of a cohort of 400,000 NZ primary care patients shows that people with severe mental illness have a significantly increased risk of CVD even after adjusting for the standard CVD risk factors. As a result, CVD risk is a double blow for this vulnerable population group because they also have a higher prevalence of most of the standard CVD risk factors. As this population group typically has many health-related issues to cope with, in addition to their physical health, they certainly need extra support to help them reduce their CVD risk. 

Last updated: 16 Jul 2019 8:39am
Declared conflicts of interest:
None.

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