"Persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability." United Nations Convention on the Rights of Persons with Disabilities
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The United Nations Convention on the Rights of Persons with Disabilities states that “persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability”.
Unfortunately for people living with mental illness, especially severe mental illness, this equality – which includes the right to good mental health, physical health and wellbeing, the same access to timely and quality health care and the other supports and services critical to a contributing life – is largely a dream.
People living with mental illness experience higher rates of poor long-term physical health than the rest of the population and for people with psychotic illnesses, the rates are startlingly higher. This is particularly the case with heart disease and diabetes.
Conversely, people whose physical health is poor are more likely to develop depression, anxiety and other common mental health issues.
Conditions such as chronic pain, asthma, severe headaches or migraines, arthritis, epilepsy, kidney disease and stroke are all experienced by people with psychosis at higher rates than the general population. Concerning levels of hepatitis, HIV, deficiency anaemias, Parkinson’s disease, injury and poor dental health have also been highlighted among people with mental illness.
It’s clear that a holistic approach is needed to ensure adequate, equitable and appropriate care and support of our mental health and our physical health. We must be cared for as more than the sum of our parts or, indeed, our conditions.
In that context we also need to pay attention to the particular needs of Aboriginal people, those from culturally and linguistically diverse backgrounds, those living in rural and remote communities, people who are lesbian, gay, bisexual, transgender and intersex as well as taking into account associated issues such as disability or drug and alcohol misuse.
- active engagement of all relevant portfolios, across governments, noting the importance of a rehabilitation and recovery framework
- active engagement and participation of all levels of health care and across all specialities, particularly in primary health care
- health professionals to consider and communicate the impact of treatment, including on physical health, and actively manage that treatment in partnership with the individual.
- to strengthen the workforce and capacity of general practice, community health services, specialist health services, the community-managed sector and allied health disciplines
- partnerships to enhance connections with the chronic disease prevention sector
- to adopt a recovery-oriented approach to medication where it is seen as one tool among many that a consumer may choose
- the risks of long-term use of medications to be monitored and to research and maximise the use of non-pharmacological strategies - we must engage consumers and their families and carers in promoting positive lifestyle choices and developing appropriate care
- to build physical health into the recovery journey so that mental health consumers have easy access to physical health assessments. Funding should support integrated delivery of services.
We also need specific health interventions in relation to smoking, nutrition and physical activity. These interventions should include:
- promoting ideas such as smoking reduction and using existing peer-to -peer support services to promote healthy lifestyles
- informing and training specialist clinical mental health services about nutrition
- improving access to dietitians in community health and, in that sector, prioritising people with mental illness
- providing specialist mental health services with information and training on the benefits of physical activity and motivational techniques
- evidence-based physical activity programs for people living with serious mental illness, including those in bed-based clinical rehabilitation services
- working with key groups such as local government and sport and recreation organisations to expand service models to include people living with a serious mental illness.
- Heart or circulatory conditions exist in 16% of the general population, and in 27% of people with psychosis.
- 6% of the general population have diabetes, 21% of people with psychosis have diabetes
- Half of the people with psychosis have metabolic syndrome
1/3 of people with psychosis are at risk of a cardiovascular event in five years
Source material for content on this page is from the Living Well Report