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ivana
Senior Contributor

How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

Some people with mental illnesses have a life span of approximately 20 years lower then other people,and even lower then Aboriginals.
It's primarily due to neglect from doctors.
Articles/studies like the below have been coming out for years,but no one takes any action regarding it.
http://www.theaustralian.com.au/news/health-science/disease-kills-mental-health-patients-earlier-rep...

Often people try to say it's the Governments fault and they should provide money for this area but to me the fault lies not just with limited funding but also the pure stigma and neglect that comes from many in the Medical Profession that no one seems to have the desire,or courage,to address.
Reality is,doctors often view a person with severe mental illness as that is their IDENTITY,instead of seeing them as a person like every other person.
When they complain of physical issues it is often not taken as seriously as when others do and is dismissed as either anxiety,Somatisation disorder or delusion from their Mental Illness.
Many doctors have a polarising attitude where it's like they believe a person can either have a mental illness or a physical one but not both.
I don't see the life span and health of people with M.I increasing until the deeply ingrained stigma from the Medical Profession is also challenged.
For example:if someone with Schizophrenia sees an Endocrinologist for physical symptoms that doctor will minimalise and dismiss all their complaints due to the judgments and preconceived notions they hold about them and same goes for Neurologists etc so how can such a huge problem be addressed?

19 REPLIES 19

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

Sadly the article is subscriber only so I can read it.

I do agree though and it's a huge problem that I think could be alleviated by doctors just doing their jobs and stop using our mental health as an excuse for not acting.  After 3 surgeries for a malignant melanoma (stage 3) I went to see the doctor about a suspicious freckle and was told I was paranoid.  I left the surgery in tears.  A year later another doctor saw the same freckle and referred me to have it checked out.  When I told her what had happened she said you've earned the right to be paranoid, don't let them bully you.  I've lost count of the number of times I've been ignored and shunted sideways, heck I'll need a knee replacement because of doctors ignoring my concerns.

Not just me either; I work in the mental health field and it just goes on and on so much no one bothers seeing a doctor any more and their health suffers for no good reason.

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

Oh,sorry I didn't realise.
I've copy and pasted the article below.

I agree that after so many bad experiences people don't go anymore because they know the sort of treatment they'll receive.
Did the doctors you visited regarding the freckle and other stuff know beforehand that you had some Mental illness symptoms or did they not know your "history"?


Disease kills mental-health patients earlier: report
JOEL MAGAREY THE AUSTRALIAN NOVEMBER 24, 2014 12:00AM
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MENTAL health patients are dying from preventable physical illnesses at the “appalling” estimated rate of 9000 excess deaths a year, it can be revealed, as new evidence suggests they receive fewer life-saving treatments and wait longer for them than other Australians.

The scale of the excess death numbers, estimated by a leading authority for The Australian as part of an investigation into physical health care of people with mental illness, has disturbed top-level mental health advocates.

The investigation can also reveal Australians with severe mental illness have such bad physical health they been identified as the most “medically vulnerable” of any equivalent patient population in the world.

University of WA research professor David Lawrence produced the 9000 deaths estimate by nationally extrapolating from comprehensive data on excess deaths among Western Australian users of state mental health services.

Australian college of psychiatrists president Murray Patton said the figure was “appalling” and a “pointer … to the fact that we need to do much better in this regard”, while former national mental health commissioner Janet Meagher branded it “disgraceful”.

The data collated by Professor Lawrence and colleagues has shown that far more people with mental illness die prematurely from common preventable illnesses — predominantly heart disease and cancers — than from suicide, though people who die from suicide die younger on average. The national suicide has most recently been estimated at about 2500.

Professor Lawrence’s data shows state mental health service patients die on average from all causes 14 years earlier than average Australian life expectancy, though other published mortality studies suggest Australians with severe mental illness die up to 36 years early, “many …(from physical) conditions that are preventable”.

The excess deaths from physical illness among people with mental disorders are considered to have multiple causes — including higher smoking rates, poorer diet and less physical activity among those with mental illness — but experts told The Australian the “inadequacy of physical health care” added to them significantly.

Blasting health professionals for “neglect and nihilism”, Sydney University psychiatry professor Tim Lambert said much early mortality was explained by people with mental illness not being provided “the services that everyone else expects”.

“A very significant part of the problem … is the lack of (physical health) screening, detection, follow-up and management”.

Experts consulted by The Australian, including Professor Lambert, acknowledged health professionals were often required to do complex work with insufficient resources and that system problems such as segregation of services lay behind much “inadequate” care.

Meanwhile, an Australian research team led by University of Queensland researcher Steve Kisely has identified that following diagnosis with a cancer, people with mental illness receive significantly lower rates of appropriate treatment and die from the cancer 41 per cent more often.

Professor Kisely said the research, published in the Archives of General Psychiatry, showed people with mental illness were less likely to get appropriate surgery even taking into account the stage at which they had presented.

“They are less likely to get chemotherapy, they are less likely to get radiotherapy, and they have got longer waits to actually get appropriate surgery”.

Dr Kisely said the findings were due to both patient and health professional factors but that he believed stigma contributed.

Writing in the Australian and New Zealand Journal of Psychiatry, British expert Alex Miller has said Australians with severe mental illness have “such profound rates” of heart disease and diabetes that they have overtaken the equivalent patient population in the United States “at the top of the list of medically vulnerable patients”.

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

At that stage all they knew was that I had a history of depression, suicidal ideation and anxiety as it was pre bipolar.  

 

Good article.

I find it interesting that they cite a lack of resources to adequately treat but the miss entirely the prevalence of doctors ignoring patients concerns?  The fact that they say people with MI will have longer waiting times to get surgery is quite interesting since I wasn't aware of MI being a deciding factor in whether or not you have chemotherapy?

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

Exactly.
Doctors are still put on pedestals and the "elephant in the room" is being missed because people are either in disbelieve that many doctors could act this way or are ignorant regarding it.

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

The other problem too is that PSychiatrists themselves often disbelieve that their patients can have real physical problems.
With some it's like once they qualify to become a Psychiatrist they filter everything through that so for example if their patient complained of rapid heartbeat, instead of the Psych keeping their mind open that the problem could be either heart disease,problems with the autonomic nervous system,infection caused etc or anxiety,they will ONLY see it as having to be from anxiety.
Often,only with the threat of potential litigation do they decide to look at other alternatives.
It's like they get tunnel vision and all the medical stuff they learned at Uni gets thrown out the window.
Psychiatrists are doctors too so it time they started doing Physical checks on their patients too and I don't mean just the basic panel of blood tests (ie blood count,LFT,) but other things such as thyroid function studies and inflammatory markers etc as in some instances mental symptoms can be caused from these things too.
General speaking,there needs to be a removal of the current paradigm in Medicine with separates Psychiatry from Physical Medicine because in reality there is no separation.
Eg:people wih depression have been found to have neuroinflammation,oxidative stress markers,sometimes vitamin deficiencies etc- all of this is real and physical but many doctors in this country seem so behind regarding all of this.

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

That smiley shouldn't be there.

Warning: this skull may contain some sanity

Hi Ivana and JT,

I've been there, with a doc who was a GP and ignored the advice of a digestive tract specialist.  The specialist had seen my esophagus and stomach and duodenum via a gastroscopy.

Feller had no problem recommending codiene and oxycodone be prescribed by the GP.  In writing no less.  The GP said just take painkillers. FAIL.

So I didn't go back to that GP.  Anyway, I try to have my sane face on when I see my current GP.  I keep the face in a jar by the door, like Eleanor Rigby.

Treat your GP like a human and you'll get lots of fun, useful meds.  I think it was JT who said they managed to find a GP who treated people like they had a sane brain.  Its probable that after the first couple dozen consults for the day the poor feckers switch to autopilot.

So just make sure they see a person when you get to the consulting room. 

Re: How do we stop doctors neglecting Physical Illnesses of people with Mental Illnesses?

Yes and our health is a holistic thing.  Mind and body are one unit; no one component can lose function without affecting the rest.  The sooner that is appreciated by the treating team the earlier we can improve some life expectancy outcomes.

Re: Warning: this skull may contain some sanity

Bat guano-sorry,I didn't quite understand...are you suggesting that people would get further with doctors if they act "normal"?
While that's probably true,that won't do anything to breakdown the stigma/preconceptions/judgments etc from many doctors.