2013-05-22T07:08:10-04:00 Mark Davies http://www.huffingtonpost.co.uk/author/index.php?author=mark-davies Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Mark Davies Good old fashioned elbow grease. tag:www.huffingtonpost.com,2012:/theblog//3.1373093 2012-03-22T13:52:01-04:00 2012-05-22T05:12:01-04:00

Mark Davies http://www.huffingtonpost.com/mark-davies/
Imagine being prescribed heavy doses of medication without being informed about potentially life-threatening health risks that could result from it. Or being turned away from A&E when you're in serious physical pain because the hospital staff think the problems are all in your mind.

Sound scary? Alarmingly, these kinds of experiences are all too common for people affected by severe mental illness, who die on average 20 years younger than the general population, mainly from preventable physical health conditions.

They are also 2-3 times more likely to develop Type 2 diabetes, and are twice as likely to die from heart disease. While a recent report by the King's Fund highlighted concerns about the mental health of people with long-term physical illness, the flip side is that the physical health needs of people with mental illness are too often overlooked and neglected.

Medication is a huge factor here, particularly antipsychotics, which often cause dramatic weight gain, in turn leading to a host of other problems including heart disease, diabetes, high cholesterol and blood pressure, stroke, colon cancer and sexual dysfunction.

However, too often these very serious side-effects of medication are not adequately explained by clinicians. Research by the Care Quality Commission found that more than half of people taking medication for mental illness felt that they could have been given enough information about the physical side effects, and 28 percent were not told about side effects at all. This leaves people less able to make informed decisions about their medication or to raise concerns about potential physical problems arising from it.

As well as being unexplained, these health risks are often unmonitored. The NICE guidelines recommend that GPs and other primary healthcare professionals should monitor the physical health of people with schizophrenia at least once a year, but a recent survey by my organisation Rethink Mental Illness found that less than a third of people using mental health services had been offered an annual physical health check.

Too often, responsibility for the physical health of people with mental illness falls between the gaps of primary and secondary care. People feel caught between their GP and their psychiatrist or mental health team - their psychiatrist says that physical health problems should be treated by their GP, while their GP dismisses the problems as a manifestation of mental illness.

This is known as 'diagnostic overshadowing' - when people's physical health problems are written off as just part of their mental health condition. Our supporters can tell horror stories about seeking treatment for physical health problems, but being rejected by clinicians who tell them there is nothing wrong with them or that their problems are psychosomatic, just because they have a history of mental illness.

The result is that people endure all kinds of ailments, from headaches to irritable bowel syndrome, without receiving treatment for years, or at all. It also results in premature but completely preventable deaths.

Lifestyles factors also contribute greatly to physical ill health, and poor diet, lack of exercise, alcohol and substance abuse, and smoking all play a big part. This is perhaps unsurprising when you consider that people affected by mental illness are often socially isolated, victims of stigma and discrimination, and not given the right support or treatment they need from health workers

Of course, there are many professionals in both primary and secondary care who do take the time to speak to people with mental illness about their physical health and who do take their concerns seriously. Unfortunately, they are the exception rather than the rule.

The good news is that it doesn't have to be this way, and there are simple steps that professionals can be take to ensure that people's physical health physical complaints do not go undetected. Rethink Mental Illness has recently launched a range of resources, including a free online training package and a physical health check tool, to help professionals monitor people's physical health needs and to address any problems that arise.

This is part of our 20 Years Too Soon campaign, which aims to raise awareness of the fact that so many people with mental health issues are dying from easily preventable physical illnesses.

Most importantly, we want to encourage professionals from both primary and secondary care to talk more often to people with mental illness, and to each other, about physical health. We need to stop people with mental illness falling through the gaps - their lives depend on it. ]]> tag:www.huffingtonpost.com,2011:/theblog//3.1078831 2011-11-06T18:00:00-05:00 2012-01-06T05:12:01-05:00

Mark Davies http://www.huffingtonpost.com/mark-davies/
A random example from an online discussion perhaps, but it's indicative of a common view that cannabis is a harmless rite of passage. In reality, it can be much more serious.

Other examples of this laid back view about a potentially very harmful drug are rife. A colleague reports that one of her friends had been smoking the occasional joint to ease the pain of chemotherapy. On the wonderful news that she had the all-clear from breast cancer, she handed over the leftovers to her (extremely grateful) teenagers.

In an article headed 'Mum swaps Merlot for marijuana' £ in the Times earlier this year, the writer Lucy Cavendish described how it felt "terribly communal" to get together with friends to share joints.

Her rediscovery of the drug after 20 years is not uncommon. The Independent Drug Monitoring Unit figures suggest that 2.6 million adults use cannabis, with its use among the over-30s gradually increasing since 2004.

It's certainly true that smoking cannabis is far from rare. What is alarming however, is the view that doing so is pretty much harmless and that it's inevitable that most teenagers will dabble with it. The argument goes that it's part of growing up, it's not a big deal - even President Obama 'inhaled frequently' in his younger days.

Questioning this received wisdom is likely to provoke rolled eyes and sighs. To an extent, I understand why. For a start, I've inhaled too, albeit around 20 times in 20 years and not at all for 10. Most of the people I know have done too. And yes, there are much more dangerous drugs around, binge drinking is just as, if not more, harmful overall.

What is worrying, however, is the apparent ignorance which exists about the link between cannabis and severe mental illnesses such schizophrenia.

I was pretty ignorant too, until I joined Rethink Mental Illness just over a year ago. Since then, I've been taken aback by the number of people I've come into contact with who have schizophrenia and were heavy cannabis users in their teens and early 20s. It's a story we come across all too often. I met a parent who told me they knew their teenager smoked 'a bit of grass', but didn't think too much of it until he started having delusions about the devil.

Another told me about his desperation, trying to protect his child from the forces "destroying his beautiful mind".

Let's be clear, Rethink Mental Illness does not believe that every teenager who has the odd joint is going to wake up the next day with a full-blown mental illness. But what we are saying is that cannabis is not the 'safe' drug many believe it to be, and that we urgently need to get real about the potential risks.

Cannabis is a bit like nuts. I can eat nuts without fear, but my son had such a severe reaction to eating brazil nuts that we now have to carry adrenalin with us at all times. Cannabis is the same, some people react very badly to it, some hardly at all.

Studies suggest that cannabis smokers with a genetic vulnerability to psychosis are more likely to develop it, and at an earlier age. One study found that people who had used the drug before the age of 15 could quadruple their risk of experiencing psychosis. Given that, one has to question whether it is a risk worth taking. It's certainly important to challenge lazy thinking about the dangers.

One of the problems is that the cannabis many parents remember from their youth is a completely different substance to the one around today. Levels of THC, the dominant psycho-active agent in cannabis has been increasing year-on-year, resulting in a much more potent drug.

Despite this, Rethink Mental Illness didn't support the reclassification of cannabis from class C to B in 2009. That's because we don't believe that fiddling around with categories is the most effective way to tackle the problem: indeed, our own polling has shown only 3% of people would be motivated to quit cannabis because of stricter laws.

The critical issue is around education. The view that smoking cannabis is nothing to get worked up about needs to be challenged more effectively. Instead of classifying and re-classifying, government time and money would be much better spent on educating young people who smoke cannabis about the very real game of Russian roulette they're playing with their mental health.]]>