Higher Death Rates for the Mentally Ill
Researchers have found higher-than-expected death rates from physical health problems for people with mental illness. Dr. Alex Mitchell of Leicester University, U.K., and colleagues in Australia examined findings from 22 studies including 825,754 patients, on outcomes after “acute coronary events” such as heart attack. All the studies were based in the U.S.
There was increased mortality in patients who had been diagnosed with severe mental illness. This group was also 14 percent less likely to receive essential coronary care procedures following their heart attack, says Dr. Mitchell. He explains that such procedures, which include revascularization, coronary artery bypass graft and angioplasty, are effective at improving outcomes.
Ten of the studies looked at care for people with schizophrenia. These found that schizophrenic patients received just half the usual rate of intervention.
Overall, there was an 11 percent higher mortality rate in the year after acute heart disease for those with psychiatric diagnoses. Full results are published in the British Journal of Psychiatry.
“People with known mental health conditions have higher background rates of cardiovascular risk factors such as smoking, inactivity, and obesity,” said Dr. Mitchell. “We already know that this is reflected in a higher rate of heart disease but what we demonstrate here is that mortality is greater even after patients come under healthcare.
“We don’t yet know the reason for these poorer outcomes but it is worrying that we also find such patients may receive less frequent life-saving interventions. Patients with significant mental health problems can be considered a vulnerable group who should be receiving at least equal and possibly enhanced care.”
He said we urgently need to know whether patients are declining treatment, or it is not being offered equally to all patients.
The authors write, “Further work is required to explore whether these factors are causally linked and whether improvements in medical care might improve survival in those with mental ill health.”