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Dying 20 Years Too Soon

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People with mental illness die 20 years younger than average, often from preventable physical conditions - but it doesn't have be that way.

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.

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